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X176
X176 – Sialogram
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A sialogram is a diagnostic radiology examination of the salivary ducts and glands. This procedure involves the injection of a contrast material into a salivary duct, followed by X-ray imaging.
According to the Schedule of Benefits, this service is comprised of two components:
• Technical Component (H): The fee for the technical aspect of the procedure, performed in a facility. The Schedule lists this as $29.80.
• Professional Component (P): The fee for the physician's interpretation and report. The Schedule lists this as $11.35.
As per , the claim for the technical component is submitted with suffix B and the professional component with suffix C. The technical component (H fee) is not eligible for payment if the service is rendered outside a hospital.
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
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