X193 – Microradioscopy of the hands
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Microradioscopy of the hands is a diagnostic radiology examination. Payment for this service is divided into a professional component and a technical component. Professional and Technical Components: - The Professional Component (`P`) is for the physician's interpretation of the examination. - The Technical Component (`H`) is for the use of the equipment and personnel. Per general payment rules, the technical component is not eligible for payment if the service is rendered to a hospital in-patient or an out-patient who is admitted to the same hospital within 24 hours for the same condition. The technical component listed with an 'H' is also not eligible for payment when rendered outside a hospital, as it is intended for services in an Integrated Community Health Services Centre (ICHSC). See and for details.
When to Use
- Use X193 for specialized high-resolution imaging of the hands when standard X-ray codes are insufficient for the required diagnostic detail.
- Use this code when providing the professional interpretation component for microradioscopy performed in an authorized diagnostic facility.
Common Pitfalls
- Billing the technical component (H) for services rendered outside of an Integrated Community Health Services Centre (ICHSC) will result in automatic rejection.
- Attempting to claim the technical component for hospital in-patients or out-patients admitted within 24 hours of the service is a violation of general payment rules and will trigger an audit.
- Failure to ensure a valid referral from a physician, nurse practitioner, or oral maxillofacial surgeon is present will lead to claim rejection under GP111 requirements.
Billing Tips
- Ensure the professional component is billed separately from the technical component to prevent processing errors in the claims system.
- When providing urgent, non-elective interpretations in a hospital setting, verify eligibility for C108 or C110 premiums, as these are specifically designed to supplement diagnostic radiology services.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
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