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X171
X171 – Lymphangiogram
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A lymphangiogram is listed under Miscellaneous Examinations within the Diagnostic Radiology section of the Schedule of Benefits. It has a technical component (
H fee) and a professional component (P fee).Referral requiredFrom: Physician, NursePractitioner, Midwife, OralMaxillofacialSurgeon
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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