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X213
X213 – Scapula - three or more views
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A radiological examination of the scapula which includes three or more views. This service is comprised of a technical component (performing the X-ray) and a professional component (interpretation). Per , the technical component is only payable to physicians in specific non-hospital settings (e.g., Independent Health Facilities) and not in a hospital, where it is funded through the hospital's budget. The professional component is payable to the interpreting physician regardless of setting.
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
All insured services must be documented in the patient's medical record, establishing that the service was provided, medically necessary, and is the same service for which the account is submitted.
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 this upon request by the MOH.
The physician must have the necessary training and experience to personally render the technical component of the service.
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