X192 – Mammary ductography
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Mammary ductography is a diagnostic radiology procedure listed under Miscellaneous Examinations. The service is paid as two separate components: - The Professional Component (P), which covers the physician's interpretation of the exam (fee: $10.65). - The Technical Component (H), which covers the use of equipment and supplies (fee: $25.05). As per , the claim for the technical component is submitted using the fee schedule code with the suffix B, and the claim for the professional component is submitted using the fee schedule code with a suffix C.
When to Use
- Use X192 when performing a diagnostic mammary ductogram to investigate pathological nipple discharge.
- Use this code for the professional interpretation (suffix C) and the technical facility/supply component (suffix B) as a split-billing procedure.
Common Pitfalls
- Failing to submit two separate claims (one with suffix B for the technical component and one with suffix C for the professional component) will result in incomplete payment.
- Attempting to bill the technical component (suffix B) without maintaining the required quality assurance documentation is a significant audit risk.
Billing Tips
- Ensure the technical component (X192B) and professional component (X192C) are submitted as distinct claim lines to satisfy the split-component payment structure.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
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.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.