X219 – Hand - four or more views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Radiological examination of the hand involving four or more views. This service is distinct from X054, which is for two or three views. This service includes a professional component for interpretation and reporting, and a technical component for performing the imaging itself. The technical component is subject to specific payment rules outlined in the General Preamble.
When to Use
- Use X219 when a complex hand injury requires four or more distinct radiographic views to evaluate fractures or dislocations, such as specific scaphoid or carpal series.
- Select X219 over X054 when the clinical protocol necessitates additional oblique or specialized views beyond the standard three-view series.
Common Pitfalls
- Billing X219 for a standard three-view hand series, which is strictly defined under X054; this will lead to rejection or audit recovery.
- Failing to document the specific clinical justification for the fourth view, which is required to substantiate the higher-intensity billing code.
Billing Tips
- Ensure the radiology report explicitly lists the four or more views performed to support the use of X219 over X054 during a potential audit.
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 the above upon request by the MOH.
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