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X401

X401CT head with IV contrast

OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

This service is for a computed tomography (CT) scan of the head, performed with the administration of intravenous (IV) contrast material. As a diagnostic radiology service, it includes all common elements of an insured service as described in the Schedule of Benefits on pages -.

When to Use

  • Use X401 for contrast-enhanced CT head studies where the clinical indication requires vascular visualization or lesion enhancement, provided it is not a combined 'with and without' study.
  • Use X401 when the study is performed as a single-phase contrast-enhanced scan, distinguishing it from X188 which is strictly reserved for multi-phase 'with and without' contrast protocols.

Common Pitfalls

  • Billing X401 in conjunction with X188 for the same patient encounter will result in an automatic rejection, as these are mutually exclusive codes for the same anatomical site.
  • Attempting to bill E874 as an add-on to X401 when the contrast administration was performed solely for the perfusion study rather than the diagnostic head CT is a common audit trigger.

Billing Tips

  • Ensure E874 is only appended to X401 when the perfusion study is part of an acute stroke investigation and the interpretation is finalized within the critical therapeutic decision-making window.
  • When performing urgent after-hours interpretations via PACS, select the appropriate E-series premium (E406, E407, or E408) based on the time of service, ensuring the 3-hour turnaround requirement is met to avoid claim rejection.
Provider Fee$0.00
Non-Anaesthetist Fee$64.95

Effective: April 1, 2025

Category

D. Diagnostic Radiology

Subcategory

DIAGNOSTIC RADIOLOGY

Service Type

Diagnostic

Code Classes

Diagnostic Radiology

Referral RequiredFrom: Physician, NursePractitioner, DentalSurgeon, OralMaxillofacialSurgeon

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