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X138
X138 – Percutaneous antegrade pyelogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Percutaneous antegrade pyelogram is a diagnostic imaging procedure of the genitourinary tract. This service is itemized with two components: a technical fee (H) of $21.70 and a professional fee (P) of $9.00 for the interpretation.
When to Use
- Use X138 for the diagnostic imaging component of a percutaneous antegrade pyelogram when performed in a hospital setting.
- Select X138 when the procedure is specifically an antegrade study, distinguishing it from retrograde studies like X137.
Common Pitfalls
- Billing the technical component (H) for an inpatient or a patient admitted within 24 hours of the procedure is a direct violation of the payment adjustment rules.
- Attempting to bill X138 in conjunction with other special visit premiums (C102-C110) for the same patient encounter will result in rejection.
Billing Tips
- Ensure the professional fee (P) is claimed separately from the technical fee (H) if your billing software requires manual itemization, though most systems handle the split automatically.
- If performing this procedure on an urgent basis after hours in a hospital, ensure you select the appropriate C-series premium (C108, C109, or C110) based on the time and patient sequence, as these are the only eligible add-ons.
Provider Fee$0.00
Surgical Assistant Fee$24.70
Non-Anaesthetist Fee$9.00
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 that establish the service was provided, is the service for which the account is submitted, and was medically necessary.
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