X156 – Arthrogram, tenogram or bursogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
No specific description for billing code X156 was found in the provided General Preamble documents. The 'X' prefix typically corresponds to diagnostic imaging procedures found in the Diagnostic Radiology section of the Schedule of Benefits. Refer to the full Schedule of Benefits for detailed information on this service.
When to Use
- Use X156 for the professional component of performing an arthrogram, tenogram, or bursogram when contrast media is injected under imaging guidance.
- Select this code when documenting the procedural aspect of the examination, distinct from the technical imaging fee or the subsequent radiologist interpretation.
Common Pitfalls
- Billing X156 as a stand-alone service without a corresponding diagnostic imaging interpretation code, which may trigger audit flags for incomplete service records.
- Failing to ensure the referral source is a physician, nurse practitioner, or oral maxillofacial surgeon, as required by GP111:125.
Billing Tips
- Apply the appropriate age-based premium (e.g., AGE_PREMIUM_LT16Y) if the patient meets the specific age criteria, as X156 is classified as a clinical procedure associated with a diagnostic radiological examination.
- If performing the procedure after hours in an emergency setting, ensure the correct 'E' series premium (E409-E413) is appended based on your provider status and the time of the procedure.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology, Clinical Procedures associated with Diagnostic Radiological Examinations
All insured services must be documented in appropriate records. The Act requires that the record 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.
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