X412 – Computed tomography of extremities - without IV contrast
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service provides for a Computed Tomography (CT) scan of one or more extremities, without the use of intravenous (IV) contrast material. It is listed under the Diagnostic Radiology section of the Schedule of Benefits and is typically performed to diagnose injuries or conditions affecting the limbs.
When to Use
- Use for non-contrast CT imaging of extremities to evaluate suspected fractures or bony abnormalities when standard X-rays are inconclusive.
- Use for assessing soft tissue foreign bodies or calcifications in the limbs where IV contrast is not clinically indicated or required for diagnostic clarity.
Common Pitfalls
- Billing X412 alongside X413 or X127 for the same study will trigger an automatic rejection due to mutual exclusivity.
- Attempting to bill X412 for studies requiring contrast will lead to audit discrepancies; ensure the clinical documentation explicitly justifies the lack of contrast.
Billing Tips
- Ensure the referral source is documented as a physician, nurse practitioner, or oral maxillofacial surgeon to meet the mandatory referral requirement.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
All insured services must be documented in appropriate records that establish: 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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