X421 – Multislice sequence
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
This service provides a multislice sequence Magnetic Resonance Imaging (MRI) of the head. A repeat scan in another plane or with a different pulse sequence can be claimed using X425. Magnetic resonance spectroscopy can be performed in conjunction with this service and claimed using the add-on code E875. This diagnostic service can be referred by a physician, nurse practitioner, or oral and maxillofacial surgeon under specific conditions outlined in the Schedule.
When to Use
- Use X421 as the primary billing code for the initial multislice sequence MRI of the head.
- Use X421 when performing a standard head MRI, reserving X425 specifically for subsequent scans in different planes or with different pulse sequences.
Common Pitfalls
- Do not bill X421 and X425 as a single procedure; they must be claimed separately to reflect the distinct pulse sequences or planes.
- Avoid claiming E875 more than once per patient per day, as it is strictly limited to a single occurrence regardless of the number of sequences performed.
- Ensure that PACS-based interpretations are not billed with hospital-based special visit premiums (C102-C110), as these are mutually exclusive.
Billing Tips
- If performing magnetic resonance spectroscopy in addition to the head MRI, always append E875 to the X421 claim to ensure the flat fee is captured.
- When interpreting urgent studies via PACS, verify that the interpretation is transmitted within three hours of study completion to remain eligible for the E406, E407, or E408 premiums.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
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