X154 – Penis
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiology examination of the penis. This service is comprised of two distinct components that are claimed separately: Professional Component (P), representing the physician's work in interpreting the image and providing a report, and Technical Component (H), representing the facility costs. The technical component (H) is not eligible for payment if the service is rendered to a hospital in-patient; or to an out-patient who is subsequently admitted to the same hospital within 24 hours for the same condition; or if rendered outside of a hospital (Source: ).
When to Use
- Use X154 for diagnostic radiological imaging of the penis when medically necessary to evaluate trauma, suspected masses, or vascular pathology.
- Use this code when providing the professional interpretation (P) for a diagnostic study performed in a hospital or clinic setting.
Common Pitfalls
- Claiming the technical component (H) for services rendered to hospital in-patients or out-patients admitted within 24 hours, which is strictly prohibited.
- Attempting to bill the technical component (H) for services performed outside of a hospital setting, as this component is ineligible for payment in those environments.
- Failing to maintain the required quality assurance documentation, which is a mandatory prerequisite for claiming the technical component (H).
Billing Tips
- Ensure the professional (P) and technical (H) components are claimed as separate line items to avoid processing errors.
- Verify that the referring physician or nurse practitioner is documented in the patient record, as a valid referral is mandatory for this diagnostic service.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
To claim the technical component, the physician must have the necessary training and experience to personally render the service.
To claim the technical component, the physician must maintain documentation that describes the process by which they monitor quality assurance in accordance with professional standards.
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the service, including data acquisition, reporting, and record keeping.
Male
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.