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X178
X178 – No signs or symptoms - bilateral
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
X178 is a bilateral mammogram performed using dedicated equipment. It is intended for individuals who do not present with signs or symptoms of breast disease, but where the mammogram is requested as a screening or surveillance tool due to identified risk factors, in accordance-with established clinical practice guidelines. This service is distinct from diagnostic mammograms for symptomatic patients (e.g., X185). The service has two components as listed in the Schedule of Benefits: a professional component (P) for interpretation and a hospital technical component (H) for the procedure itself. See also X172 for the unilateral equivalent.
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
The sole reason for the request for a mammogram must be for an individual with identified risk factors in accordance with clinical practice guidelines.
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
For the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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