X116 – T-tube cholangiogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A T-tube cholangiogram is a diagnostic radiology procedure used to examine the bile ducts. This procedure involves the injection of a contrast medium through a T-tube that has been placed in the common bile duct, typically after surgery, to visualize the biliary tree. The service is divided into a technical component (X116-H) and a professional component (X116-P), which are claimed separately. As per , the professional component is claimed with suffix C, and the technical component is claimed with suffix B.
When to Use
- Use X116-P for the professional interpretation of a T-tube cholangiogram performed to evaluate biliary patency or identify retained stones post-operatively.
- Use X116-B for the technical component when providing the imaging equipment and contrast administration in an eligible outpatient setting, provided the patient is not admitted within 24 hours.
Common Pitfalls
- Billing the technical component (X116-B) for hospital in-patients or patients admitted within 24 hours of the procedure will result in automatic rejection per GP11.
- Failing to separate the professional (suffix C) and technical (suffix B) components into distinct claims will cause processing errors.
- Claiming the technical component for services rendered outside of a hospital setting is ineligible for payment.
Billing Tips
- Ensure the professional component (X116-C) is submitted by the interpreting radiologist, while the technical component (X116-B) is submitted by the facility or physician responsible for the equipment and quality assurance.
- If the procedure is performed urgently after hours in a hospital, ensure you select the appropriate special visit premium (e.g., C104 or C110) rather than attempting to bundle it into the diagnostic code.
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 this upon request by the MOH. (Source: , )
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