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X125
X125 – CT Thorax - with and without IV contrast
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A Computed Tomography (CT) scan of the thorax. This procedure involves two sets of scans: one performed without the administration of intravenous (IV) contrast material, followed by a second set of scans performed after IV contrast has been administered to enhance the visibility of certain tissues and blood vessels. This service combines the components of a non-contrast study (X406) and a contrast-enhanced study (X407) performed during the same session.
When to Use
- Use X125 when a single clinical encounter requires both a non-contrast phase and a contrast-enhanced phase to evaluate thoracic pathology, such as characterizing a pulmonary nodule or assessing mediastinal lymphadenopathy.
- Use X125 instead of billing X406 and X407 separately, as X125 is the bundled code for a combined protocol performed during the same session.
Common Pitfalls
- Billing X406 or X407 in addition to X125 is a duplicate billing error, as X125 already encompasses both components.
- Failure to document the clinical necessity for both phases can lead to audit recovery, as the additional radiation and contrast exposure must be justified by the diagnostic requirements of the case.
Billing Tips
- Ensure the radiology report explicitly details the findings of both the non-contrast and contrast-enhanced phases to support the use of the bundled X125 code.
- If providing urgent interpretation via PACS for an acute care patient, append the appropriate E-series premium (E406, E407, or E408) to the X125 claim, ensuring all time-stamped transmission requirements are met.
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