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X124

X124 – CT Neck - with and without IV contrast

OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

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A Computed Tomography (CT) scan of the neck performed both with and without intravenous (IV) contrast material. This service includes the complete procedure, including both the non-contrast and contrast-enhanced phases of the scan, and the professional interpretation of the images. Per the General Preamble (-), this fee also includes all common elements of an insured service.

When to Use

  • Use X124 when the clinical protocol specifically requires both non-contrast and contrast-enhanced phases to evaluate neck pathology, such as vascular malformations or complex neck masses.
  • Use X124 instead of X403 or X404 when the diagnostic intent necessitates the full multi-phase imaging sequence to differentiate between anatomical structures and contrast-enhancing lesions.

Common Pitfalls

  • Billing X124 when only a single-phase study was performed, which constitutes an audit risk for misrepresentation of the service rendered.
  • Attempting to bill X124 in conjunction with after-hours premiums (E406-E408) without ensuring the interpretation was transmitted via PACS within the mandatory three-hour window.
  • Failure to document the specific clinical rationale for requiring both phases, which is essential for justifying the higher complexity of X124 compared to single-phase codes.

Billing Tips

  • Ensure the referral explicitly requests both phases, as the medical necessity for the dual-phase study must be supported by the referring physician's order.
  • When interpreting via PACS for urgent management, confirm the transmission time is clearly logged to support the eligibility of E406, E407, or E408 premiums.
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Provider Fee$0.00
Non-Anaesthetist Fee$108.30

Effective: April 1, 2025

Category

D. Diagnostic Radiology

Subcategory

DIAGNOSTIC RADIOLOGY

Service Type

Diagnostic

Code Classes

Diagnostic Radiology

Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon

All insured services must be documented in appropriate records. The record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.

X403X404

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X124 – CT Neck - with and without IV contrast | OHIP Fee Schedule | SnapBill MD