X107 – Oesophagus
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Provides for the radiological examination of the oesophagus. This service has both a professional component (P fee) and a technical component (H fee). It is specifically used when an examination of the oesophagus is performed without including the stomach, duodenum, or small bowel. Consequently, it cannot be claimed if X103, X104, X108, or X109 are also claimed for the same patient encounter.
When to Use
- Use X107 specifically for a focused radiological examination of the oesophagus where the study is limited to that organ and excludes the stomach, duodenum, or small bowel.
- Use this code when the clinical indication is isolated to the oesophagus, such as assessing for a foreign body or stricture, provided no other gastrointestinal structures are imaged during the same session.
Common Pitfalls
- Claiming X107 in conjunction with X103, X104, X108, or X109 will result in an automatic rejection as these codes are mutually exclusive.
- Attempting to bill the technical component (H fee) for services rendered outside of a hospital setting or without meeting the specific quality assurance documentation requirements will lead to audit recovery.
Billing Tips
- Ensure your documentation explicitly confirms the scope of the examination was limited to the oesophagus to justify the use of X107 over more comprehensive GI series codes.
- When providing urgent, non-elective services in a hospital, verify that you are not billing X107 alongside other special visit premiums, as only one 'first person seen' premium is payable per patient encounter.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate the above upon request by the MOH.
This service is listed with a technical component (H fee of $26.70) and a professional component (P fee of $21.40). The technical component ('H' fee) has specific payment restrictions related to hospital setting and patient status. See Eligibility Rules for details.
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