X117 – Operative cholangiogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
An operative cholangiogram is a diagnostic radiology procedure performed during surgery to visualize the bile ducts. This service is listed in the Diagnostic Radiology section of the Schedule of Benefits with a technical component (H-fee of $21.70) and a professional component (P-fee of $11.10) as per page . Billing Rules: - As per , the technical component (H-fee) is not eligible for payment when rendered outside of a hospital. - The technical component is also not payable for a hospital in-patient or for a patient who is admitted to hospital within 24 hours of the service for the same condition. - Physicians billing the technical component must meet specific training and quality assurance documentation requirements outlined on page . - The professional component (P-fee) is for the physician's interpretation of the study.
When to Use
- Use X117 for the professional interpretation of an operative cholangiogram performed during a cholecystectomy or biliary exploration.
- Use this code specifically when the radiologist or surgeon provides a formal written report of the imaging findings during the intraoperative period.
Common Pitfalls
- Billing the technical component (H-fee) for an inpatient procedure is a common audit trigger, as it is strictly prohibited under GP11.
- Attempting to bill X117 in addition to a global surgical fee for the same procedure may result in rejection if the Schedule of Benefits considers the interpretation bundled into the primary surgical code.
- Failing to maintain the required quality assurance documentation for the technical component will lead to full recovery of payments during a Ministry audit.
Billing Tips
- If the procedure is performed after hours for an urgent indication, ensure you append E409 or E410 to the professional component to capture the appropriate premium increase.
- Always verify if your hospital facility already claims the technical component, as double-billing the H-fee for the same service is a frequent cause of claim rejection.
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.
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