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X198
X198 – Splenoportogram
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Gastric freezing is a diagnostic and therapeutic procedure. Based on the fee schedule, it is eligible for payment for a primary physician and an assistant. According to the General Preamble, this service is mutually exclusive with K001 (Detention) on the same day for the same patient. The code is listed alongside other specialized assessments such as A190, A191, A192, A195, A197, A695, A795, and A895 in this restriction.
When to Use
- Use X198 when performing a splenoportogram for the diagnostic visualization of the splenic and portal venous systems.
- Use this code when the procedure is performed in a hospital setting where the diagnostic imaging equipment and radiologic support are available.
Common Pitfalls
- Billing X198 on the same day as K001 will result in an automatic rejection due to the mutual exclusivity defined in the General Preamble.
- Attempting to bill X198 alongside specialized assessments like A190 or A197 for the same patient on the same day will trigger a claim denial.
Billing Tips
- Ensure that if an assistant is utilized for this procedure, the assistant's claim is submitted with the appropriate suffix to reflect their role in the splenoportogram.
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