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X409

X409CT Abdomen - without IV contrast

OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

X409 is for a computed tomography (CT) of the abdomen without intravenous contrast. This service is not eligible for payment with X234 (CT colonography).

When to Use

  • Use X409 for routine abdominal imaging where intravenous contrast is contraindicated due to renal insufficiency or severe allergy.
  • Use X409 for non-contrast screening or follow-up of known renal calculi or calcified abdominal pathology where contrast would obscure the findings.
  • Use X409 for patients requiring abdominal imaging who do not meet the clinical criteria for contrast-enhanced studies (e.g., X410).

Common Pitfalls

  • Billing X409 in conjunction with X234 (CT colonography) will result in an automatic rejection as they are mutually exclusive codes.
  • Attempting to bill X409 for a study that required intravenous contrast; if contrast was administered, you must use the appropriate contrast-enhanced code (e.g., X410) instead.
  • Failing to account for the technical component payment adjustment rules if the patient is admitted to the hospital within 24 hours of the scan for the same condition.

Billing Tips

  • Ensure the referral documentation clearly justifies the omission of contrast to support the use of X409 over contrast-enhanced alternatives.
  • If performing this procedure after hours or on weekends in an acute care setting, verify eligibility for the appropriate Special Visit Premium (e.g., C102, C104) to maximize the claim value.
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

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