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X139
X139 – Percutaneous nephrostogram
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Percutaneous nephrostogram is a diagnostic radiology procedure listed with a technical component fee (H) of $21.70 and a professional component fee (P) of $11.10. For definitions and rules regarding technical and professional components, see , , and .
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
For the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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