X183 – Ventriculogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Ventriculogram (X183) is a diagnostic radiology procedure listed under the Miscellaneous Examinations section of the Schedule of Benefits. The fee is separated into a professional component (P fee) payable to the physician for their service, and a technical component (H fee) for the facility costs. As per of the General Preamble, the technical component is generally only payable when the service is rendered in a hospital.
When to Use
- Use X183 when performing a diagnostic ventriculogram to visualize the ventricular system of the brain, distinct from standard CT or MRI head scans.
- Apply this code for the professional component when interpreting the ventriculogram images in a hospital setting where the facility claims the technical component.
Common Pitfalls
- Billing X183 in an Independent Health Facility (IHF) without verifying if the facility is authorized to claim the technical component, as this often leads to payment rejections.
- Failing to distinguish between the professional fee (P) and the technical fee (H), resulting in incorrect submission of the total global fee.
Billing Tips
- Always append the 30% age premium if the patient is under 30 days of age, as X183 is explicitly classified as a clinical procedure associated with diagnostic radiological examinations.
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 that establish the service was provided, is the service submitted for payment, and was medically necessary.
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