X191B – Intestinal Conduit Examination or Nephrostogram - Technical Component
OHIP Laboratory Code — Genitourinary Tract · Schedule of Benefits
This code represents the technical component ('H' fee) of an intestinal conduit examination or nephrostogram. This includes the provision of the premises, equipment, supplies, and personnel required to perform the imaging. Per , the technical component is only payable when rendered in a hospital to a patient who is not an in-patient and is not subsequently admitted within 24 hours for the same condition. It is also not payable if rendered outside of a hospital.
When to Use
- Use X191B when billing the technical component for a nephrostogram performed on an outpatient in a hospital setting.
- Use this code specifically when the professional component is billed separately under X191C by the interpreting radiologist.
Common Pitfalls
- Billing X191B for a patient who is subsequently admitted to the hospital within 24 hours of the procedure, which violates the outpatient-only rule.
- Attempting to bill X191B for procedures performed in a private clinic or office setting, as the code is strictly restricted to hospital-based technical services.
- Failing to ensure the professional component (X191C) is billed by the appropriate physician, leading to potential audit discrepancies regarding the split-billing requirement.
Billing Tips
- Always verify the patient's admission status at the time of the service to ensure they do not meet the criteria for an inpatient, which would render X191B ineligible.
Effective: January 1, 2025
Diagnostic Radiology
Genitourinary Tract
Diagnostic
Diagnostic Radiology
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate the above upon request by the MOH.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.