X220 – Wrist and hand - four or more views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiological examination of the wrist and hand, involving the capture of four or more views. As a diagnostic radiology procedure, it includes both a technical component (the taking of the image) and a professional component (the interpretation by a radiologist). Refer to the Diagnostic Radiology section of the Schedule for specific fee details for each component. This service may be referred by a physician, nurse practitioner, or, under specific circumstances, an oral and maxillofacial surgeon as per .
When to Use
- Use X220 when a patient requires a comprehensive wrist and hand series consisting of four or more distinct radiographic views, typically for complex fractures or suspected pathology.
- Select X220 over X055 when the clinical requirement necessitates a higher level of detail or multiple angles beyond the standard three-view wrist or hand series.
Common Pitfalls
- Failing to separate the technical (suffix B) and professional (suffix C) components as required by the Schedule, which leads to immediate claim rejection.
- Submitting X220 for a standard three-view study, which constitutes an over-billing error; ensure the documentation explicitly confirms four or more views were performed.
Billing Tips
- Always append the correct suffix (B for technical, C for professional) to the X220 code to ensure proper processing of both components.
- If the study is performed in an emergency or urgent hospital setting, ensure the relevant Special Visit Premium (e.g., C109, C108, C110) is linked to the professional component (X220C) when criteria are met.
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.
All insured services must be documented in appropriate records to establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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