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X408
X408 – Complex head - with and without IV contrast
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A complex computed tomography (CT) scan of the head region performed both without and subsequently with the administration of intravenous (IV) contrast material. This service is defined as a 'Complex head' scan. For specific criteria, refer to the Diagnostic Radiology Preamble, paragraph 9.
When to Use
- Use X408 when a CT head protocol requires both non-contrast and post-contrast phases to evaluate complex pathology such as intracranial tumors, abscesses, or suspected vascular malformations.
- Use X408 for suspected infectious or inflammatory processes where contrast enhancement is essential to differentiate between ring-enhancing lesions and surrounding edema.
Common Pitfalls
- Billing X408 when only a non-contrast scan is performed; this is a common audit trigger that requires a downgrade to the appropriate non-contrast code.
- Attempting to bill X408 in conjunction with other head CT codes for the same patient encounter; only one diagnostic head CT code is permitted per session unless specific clinical criteria for separate studies are met.
Billing Tips
- Ensure the clinical indication for contrast is clearly documented in the report, as the 'complex' designation under the Diagnostic Radiology Preamble is contingent upon the medical necessity of both phases.
Provider Fee$0.00
Non-Anaesthetist Fee$86.60
Effective: April 1, 2025
Category
D. Diagnostic Radiology
Subcategory
DIAGNOSTIC RADIOLOGY
Service Type
Diagnostic
Code Classes
Diagnostic Radiology
Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
Complex head (see Diagnostic Radiology Preamble, paragraph 9).
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