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X184
X184 – Mammogram - unilateral (signs or symptoms)
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A unilateral mammogram performed with dedicated equipment. Per the commentary on , this procedure is for individuals with identified signs or symptoms or for the follow-up of established disease. This service has both a technical component (H fee) and a professional component (P fee). For a bilateral examination, see X185.
When to Use
- Use X184 when a patient presents with a palpable lump, focal pain, or nipple discharge requiring a unilateral diagnostic view.
- Use X184 for the follow-up of a previously diagnosed breast malignancy or suspicious lesion where only one breast requires imaging.
- Use X184 instead of X185 when the diagnostic concern is localized to a single breast, as X185 is strictly reserved for bilateral examinations.
Common Pitfalls
- Billing X184 for routine screening mammography, which must be claimed under the Ontario Breast Screening Program (OBSP) codes rather than diagnostic codes.
- Failing to append the correct suffix, using 'B' for the technical component and 'C' for the professional component, which leads to immediate claim rejection.
- Submitting X184 alongside X185 on the same day without manual review justification, as this is flagged as a duplicate or conflicting service.
Billing Tips
- Always append the E448 add-on code to the professional component (X184C) if 3D tomosynthesis was performed to ensure appropriate reimbursement for the advanced imaging.
Provider Fee$0.00
Surgical Assistant Fee$31.95
Anaesthetist Fee$19.40
Non-Anaesthetist Fee$19.40
Effective: April 1, 2025
Category
D. Diagnostic Radiology
Subcategory
DIAGNOSTIC RADIOLOGY
Service Type
Diagnostic
Code Classes
Diagnostic Radiology
Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
Use of dedicated equipment.
Must be performed with dedicated equipment.
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