X134 – Retrograde urethrogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A retrograde urethrogram is a diagnostic radiology procedure used to visualize the urethra. It involves the retrograde (against the normal flow) injection of a contrast agent into the urethra to identify abnormalities such as strictures, diverticula, or trauma. The service is comprised of two parts: a technical component (Fee H) for the performance of the imaging and a professional component (Fee P) for the physician's interpretation and report. As per , the technical component is claimed with suffix B and the professional component with suffix C, though they are listed under the single fee code X134.
When to Use
- Use X134 when performing a retrograde urethrogram to investigate suspected urethral strictures, diverticula, or post-traumatic urethral injury.
- Use this code specifically for the retrograde injection procedure; do not use it for antegrade cystourethrograms, which are billed under different codes such as X135 or X136.
Common Pitfalls
- Failing to submit both the technical component (suffix B) and the professional component (suffix C) results in incomplete reimbursement for the full procedure.
- Claiming X134 without a valid referral from a physician or nurse practitioner is a common cause for audit recovery.
- Incorrectly billing X134 for a voiding cystourethrogram (VCUG) instead of the appropriate specific code for that examination.
Billing Tips
- Ensure your documentation explicitly confirms the retrograde nature of the contrast injection to differentiate it from other diagnostic imaging codes.
- If the procedure is performed after hours in an acute care hospital for urgent management, ensure you append the appropriate Special Visit Premium (e.g., C109 or C110) to the professional component (suffix C) claim.
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 this upon request by the MOH.
The physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
The technical component is identified by the 'H' fee and the professional component by the 'P' fee.
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