All codes
X416
X416 – CT Spine with IV contrast
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service provides for a Computed Tomography (CT) scan of the spine, with the administration of intravenous (IV) contrast material. The service is insured when referred by an eligible practitioner and performed in an appropriate facility. This code is mutually exclusive with other spine CT codes for the same session, such as X412 (without contrast) and X128 (with and without contrast). See for the listing.
When to Use
- Use X416 when a CT spine study specifically requires IV contrast for diagnostic clarity, such as evaluating vascularity or enhancing soft tissue pathology.
- Select X416 for contrast-enhanced spinal imaging when X415 (without contrast) is insufficient to answer the clinical question posed by the referring practitioner.
Common Pitfalls
- Billing X416 in combination with X415 or X128 for the same patient encounter will trigger an automatic rejection due to mutual exclusivity.
- Claiming X416 for a study performed without IV contrast is a billing error; ensure the technical component reflects the administration of contrast material.
Billing Tips
- If performing an urgent interpretation via PACS after hours, ensure you append the appropriate E-series premium (E406, E407, or E408) and document the exact transmission time to satisfy audit requirements.
- Verify that the referring practitioner is an eligible source (Physician, Nurse Practitioner, or Oral Maxillofacial Surgeon) before submitting the claim to avoid eligibility denials.
Provider Fee$0.00
Non-Anaesthetist Fee$97.50
Effective: April 1, 2025
Category
D. Diagnostic Radiology
Subcategory
DIAGNOSTIC RADIOLOGY
Service Type
Diagnostic
Code Classes
Diagnostic Radiology
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