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X142

X142Subsequent test - low or medium risk patient - one site

OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

Subsequent bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) on one site. This service is insured for the prevention and management of osteoporosis or osteopenia in a 'low risk patient', who is defined as a patient not at high risk for accelerated bone loss, without prior osteopenia/osteoporosis, and with bone loss less than 1% per year on previous tests. This test is not payable if performed less than 60 months after the second (X152 or X153) or any subsequent test for a low-risk patient.

When to Use

  • Use X142 for a follow-up BMD scan on a single site when the patient remains in the low or medium risk category (FRAX <15%) and it has been at least 60 months since their last scan.
  • Select X142 when a patient has a physical deformity or prosthesis that makes imaging both the hip and spine technically impossible, necessitating a single-site study.

Common Pitfalls

  • Billing X142 before the 60-month interval has elapsed since the previous X142, X148, or baseline X145/X146 will result in an automatic rejection.
  • Submitting X142 for a high-risk patient is a billing error; high-risk patients requiring more frequent monitoring should be billed under X149 or X155 if criteria are met.

Billing Tips

  • Ensure the patient's FRAX score is documented in the chart to justify the low/medium risk classification, as this is the primary audit trigger for distinguishing X142 from high-risk codes.
Provider Fee$0.00
Surgical Assistant Fee$48.70
Non-Anaesthetist Fee$40.15

Effective: April 1, 2025

Category

D. Diagnostic Radiology

Subcategory

DIAGNOSTIC RADIOLOGY

Service Type

Diagnostic

Code Classes

Diagnostic Radiology

Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon

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