X208 – Sacro-iliac joints - four or more views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Sacro-iliac joints - four or more views. This service is a diagnostic radiology procedure. The Schedule lists a professional fee (P fee) for the physician's interpretation and a technical fee (H fee) for the facility component. As per the Schedule's General Preamble (), the technical component (H fee) is not eligible for payment if the service is rendered to a hospital in-patient or under other specific admission-related circumstances.
When to Use
- Use X208 when a formal radiological examination of the sacro-iliac joints requires a minimum of four distinct views to assess pathology such as sacroiliitis or ankylosing spondylitis.
- Select X208 over X035 when the clinical protocol necessitates a more comprehensive imaging series (four or more views) rather than the standard limited series.
Common Pitfalls
- Billing X208 for fewer than four views is a common audit trigger; ensure the imaging report explicitly documents the number of views performed to justify the code.
- Attempting to claim the technical component (H fee) for hospital-based services will result in automatic rejection, as this component is covered by the facility's global budget.
Billing Tips
- Ensure the imaging report clearly lists the specific views obtained (e.g., AP, oblique, or specialized SI joint angles) to substantiate the 'four or more views' requirement during a post-payment review.
- If performing this service as part of an urgent, non-elective hospital visit, ensure the appropriate Special Visit Premium (e.g., C109 or C110) is linked to the professional fee, provided the service is not rendered via PACS.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
Medical records must be maintained to establish that the service was medically necessary and rendered. ()
This service has a professional component (P fee) and a technical component (H fee).
The P fee is for the professional interpretation of the imaging study.
The H fee represents the technical cost of the procedure and is typically not a direct payment to the physician in a hospital setting. ()
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