X159 – Bronchogram - bilateral
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This fee code represents a specific diagnostic or therapeutic procedure. The service includes all common and specific elements as defined in the General Preamble. This encompasses preparation, performance of the procedure itself, and immediate post-procedure care. The fee for the primary physician (suffix A) is for performing the procedure. Fees for a surgical assistant (suffix B) and anaesthetist (suffix C) are calculated based on basic and time units, and are eligible for various premiums based on time of day and patient condition as outlined in the Schedule.
When to Use
- Use X159 when performing a bilateral bronchogram as a distinct diagnostic procedure in a hospital setting.
- Use this code for the primary procedural fee when the service is performed on both lungs, distinguishing it from unilateral procedures if applicable.
Common Pitfalls
- Billing X159 in addition to other diagnostic imaging codes for the same anatomical site during the same session, which may trigger a duplicate service rejection.
- Failing to document the specific bilateral nature of the procedure, which is required to justify the use of this specific fee code over unilateral alternatives.
Billing Tips
- Ensure that after-hours premiums (e.g., E409, E410) are only applied if the procedure meets the strict criteria for non-elective status or is a delayed elective procedure due to an emergency.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Procedure
Diagnostic and Therapeutic Procedures
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.
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