X431 – Multislice sequence - neck
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
Professional component for a multislice magnetic resonance imaging (MRI) sequence of the neck. This service involves the interpretation of the imaging results. A repeat scan may be performed using another plane or a different pulse sequence (X435).
When to Use
- Use X431 for the primary interpretation of a multislice MRI sequence of the neck.
- Use X431 when a standard neck MRI sequence is performed, reserving X435 specifically for subsequent repeat scans using different planes or pulse sequences.
Common Pitfalls
- Billing X431 in conjunction with PACS-based urgent interpretation premiums (E406, E407, E408) for the same patient encounter is prohibited.
- Attempting to claim special visit premiums (C102-C110) for interpretations performed remotely via PACS will result in automatic rejection.
- Failing to document the supervising physician and trainee details when the service is rendered by a trainee, as this is a mandatory audit requirement.
Billing Tips
- Ensure that if an urgent interpretation is required via PACS, you bill the appropriate E-series premium (E406, E407, or E408) rather than attempting to add special visit premiums to X431.
- When a repeat scan is medically necessary using a different pulse sequence, bill X435 as a separate line item to ensure accurate capture of the additional professional component.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
When rendered by a Medical Trainee under supervision, the medical record must identify the Supervising Physician, the Medical Trainee and level of training, the description of the service, and patient consent. The Supervising Physician must sign off on the service or the Medical Trainee must document the date and time of discussion with the Supervising Physician.
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