X234 – CT colonography
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
CT colonography is an insured service only in specific circumstances. This service includes all elements required to perform the study, including additional CT acquisition sequencing and/or post-processing, two or three-dimensional reconstruction(s), administration of contrast, and faecal tagging, if rendered.
When to Use
- Use for patients at moderate risk for colorectal cancer who explicitly refuse conventional colonoscopy after being informed of the risks and benefits.
- Use for symptomatic patients (e.g., unexplained weight loss, anemia, or GI bleeding) where conventional colonoscopy is technically infeasible or contraindicated.
- Use for surveillance in patients with a history of colonic neoplasm when clinical circumstances make CT colonography the appropriate diagnostic pathway.
Common Pitfalls
- Billing X234 in conjunction with other diagnostic radiology codes like X231, X232, or X233 will result in automatic claim rejection.
- Failing to document the specific clinical justification (e.g., patient refusal of colonoscopy or technical contraindication) in the patient record creates significant audit risk.
- Attempting to bill separately for contrast administration or 3D reconstruction, as these are explicitly included in the global fee for X234.
Billing Tips
- Ensure the referral source is a physician, nurse practitioner, or oral maxillofacial surgeon, as per GP111 requirements, to avoid invalid referral errors.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
X234 includes all elements required to perform the study, including additional CT acquisition sequencing and/or post processing, two or three dimensional reconstruction(s), administration of contrast, and faecal tagging, if rendered.`
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