What is OHIP billing code X235?

X235 is "Cardio-thoracic CT", an OHIP Laboratory code from the Ontario Schedule of Benefits (Physician Services).

How much does X235 pay?

The current OHIP fee for X235 is $0.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill X235 to OHIP?

X235 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates X235 claims against the Schedule of Benefits rules before submission.

All codes

X235

X235 – Cardio-thoracic CT

OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

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Cardio-thoracic CT is an imaging service of the cardio-thoracic structures including cardiac gating and 3D imaging post-processing, cardiac structure and morphology and computed tomographic angiography of coronary arteries (including native and anomalous coronary arteries, coronary bypass grafts) and requires imaging with contrast material(s) and which may be preceded by imaging without contrast material(s).

When to Use

Use for a clinically stable symptomatic patient with low to intermediate probability of obstructive coronary disease requiring non-invasive coronary artery assessment.
Use for evaluating suspected congenital coronary artery anomalies that are clinically relevant and require high-resolution 3D reconstruction.
Use for cardiac function evaluation or assessment of pericardial disease when MRI or echocardiography are deemed unsuitable for the patient.

Common Pitfalls

Billing X235 on equipment with fewer than 64 detectors will result in rejection, as the code explicitly requires a minimum 64-detector CT scanner.
Attempting to bill X235 in conjunction with X417, X406, X407, or X125 will cause a claim rejection due to restricted code combinations.
Failure to document the specific clinical indication from the approved list (e.g., ISS score for trauma or specific cardiac pathology) is a frequent audit risk.

Billing Tips

Ensure the claim includes all elements of the study, as X235 is an all-inclusive fee that covers contrast administration, cardiac gating, and 3D post-processing.
For pediatric patients under 16, apply the appropriate age-based percentage premium to the base fee to ensure accurate reimbursement.

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Provider Fee$0.00

Non-Anaesthetist Fee$147.50

Effective: April 1, 2025

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