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X417
X417 – Three dimensional CT acquisition sequencing
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Three dimensional CT acquisition sequencing, including post-processing (minimum of 60 slices; maximum 1 scan per patient per day).
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
Minimum of 60 slices must be acquired.
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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