X127 – Computed tomography of extremities with and without IV contrast
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service is a Computed Tomography (CT) scan of one or more extremities. It involves an initial scan without the use of intravenous (IV) contrast media, followed by a second scan after IV contrast has been administered. The fee for this service covers both the technical performance of the scan and the professional interpretation by a radiologist.
When to Use
- Use X127 when the clinical protocol specifically requires both non-contrast and post-contrast imaging of an extremity to differentiate between vascular structures and soft tissue masses.
- Select X127 over X412 or X413 when the diagnostic intent necessitates the dual-phase contrast study to evaluate for complex infections like osteomyelitis or deep-seated abscesses.
Common Pitfalls
- Billing X127 for hospital in-patients or patients admitted within 24 hours is a common error, as the technical component is not eligible for payment in these settings.
- Attempting to bill X127 in conjunction with X412 or X413 for the same extremity on the same day will result in a rejection for duplicate service.
Billing Tips
- If interpreting the study remotely for an urgent ED or inpatient case, append the appropriate Urgent PACS Premium (E406-E408) to the X127 claim to capture the professional interpretation fee.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
Medical record must document the medical necessity for the service.
For services ordered by a Nurse Practitioner or Oral and Maxillofacial Surgeon, the referral must meet the requirements outlined in the Schedule of Benefits.
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