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X128 – CT Spine - with and without IV contrast

OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

A computed tomography (CT) scan of the spine(s), performed with and without intravenous (IV) contrast. The Schedule lists a professional (P) fee only. See X415 (without IV contrast) and X416 (with IV contrast).
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
All insured services must be documented in appropriate medical records to establish medical necessity and that the service billed was the service that was rendered. See for details.
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. See .

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