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X407
X407 – Thorax - with IV contrast
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service is a Computed Tomography (CT) scan of the thorax performed with intravenous (IV) contrast, as listed in the Diagnostic Radiology section of the Schedule of Benefits.
When to Use
- Use X407 when the clinical indication requires vascular enhancement, such as investigating pulmonary embolism, aortic dissection, or thoracic malignancy staging.
- Select X407 over X406 when the diagnostic protocol specifically mandates IV contrast to differentiate mediastinal structures or vascular pathology.
Common Pitfalls
- Billing X407 when the scan was performed without contrast, which should be billed as X406 to avoid audit discrepancies regarding the service rendered.
- Attempting to bill X407 in conjunction with X125 for the same anatomical region without clear evidence of distinct diagnostic necessity, which often triggers automated rejection.
Billing Tips
- Ensure the requisition clearly specifies the clinical necessity for IV contrast to support the use of X407 over the non-contrast X406 code during potential post-payment reviews.
Provider Fee$0.00
Non-Anaesthetist Fee$75.85
Effective: April 1, 2025
Category
D. Diagnostic Radiology
Subcategory
DIAGNOSTIC RADIOLOGY
Service Type
Diagnostic
Code Classes
Diagnostic Radiology
Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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