X214 – Humerus including one joint - three or more views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A radiological examination of the humerus bone including either the shoulder or elbow joint, which involves capturing three or more radiographic views. The fee for this service is split into a professional component (P-fee) for the physician's interpretation and a technical component (H-fee) for performing the X-ray. The technical component is subject to specific payment rules when performed in a hospital setting. See for details on technical and professional component billing.
When to Use
- Use X214 when a patient requires a minimum of three radiographic views of the humerus that specifically include either the shoulder or elbow joint.
- Select X214 over X050 when the clinical suspicion of a fracture or pathology necessitates a more comprehensive series of three or more views rather than the standard two-view protocol.
Common Pitfalls
- Billing X214 when only two views were performed, which violates the minimum view requirement and triggers an automatic rejection or audit recovery.
- Failing to distinguish between the professional interpretation fee and the technical component fee, leading to incorrect submission of the H-fee versus P-fee in a hospital setting.
Billing Tips
- Ensure the requisition clearly specifies the inclusion of the joint (shoulder or elbow) to justify the use of X214 over a generic humerus X-ray code.
- If performing fewer than three views, you must bill X050 instead, as X214 is strictly reserved for three or more views.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
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.
When referred by a non-physician (e.g., Nurse Practitioner, Oral and Maxillofacial Surgeon), the referral must be documented.
This service is for three or more views. See X050 for two views.
As per , where a minimum number of services (views) is specified, with the exception of those services listed in the “Diagnostic Radiology” section of the Schedule or unless specifically stated otherwise, rendering less than the required number makes the service not eligible for payment.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.