X189 – Fluoroscopic control of clinical procedures done by another physician
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Fluoroscopic control for clinical procedures performed by another physician, billed per quarter-hour. This service involves the radiologist actively guiding or monitoring a procedure using fluoroscopy. The service has separate professional ('P') and technical ('H') fee components. As per of the Schedule, the technical component of a diagnostic service listed with an 'H' fee and rendered outside of a hospital is not eligible for payment.
When to Use
- Use X189 when you are the radiologist providing real-time fluoroscopic guidance for a procedure performed by a surgeon or interventionalist, such as a needle localization or joint injection.
- Bill X189 per 15-minute increment when your active participation is required to guide the primary physician's clinical intervention.
Common Pitfalls
- Do not bill X189 if you are the physician performing the primary clinical procedure; it is strictly for the physician providing the fluoroscopic control only.
- Avoid billing the technical component (H) if the service is performed in a non-hospital setting, as this is ineligible for payment per GP11.
- Failure to document exact start and end times in the medical record will lead to claim rejection or clawback during an audit.
Billing Tips
- Ensure the total time billed reflects only the duration of active fluoroscopic guidance, excluding preparation or post-procedure documentation time.
- Always verify that the primary physician's procedure code is distinct from your X189 claim to avoid duplicate billing flags.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology, Diagnostic and Therapeutic Procedures
The medical record must document the time when the insured service started and ended.
This service has a professional component (P) fee and a technical component (H) fee. The professional component relates to the physician's service, and the technical component covers the cost of equipment, supplies, and non-physician staff time.
Professional fee (P): $23.75
Technical fee (H): $7.30
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