X451 – Multislice sequence
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
Represents the professional component for a multislice sequence Magnetic Resonance Imaging (MRI) of the abdomen. This service is not eligible for payment when used as guidance for organ biopsy, as per the note on page of the Schedule. The service can be ordered by physicians, nurse practitioners, oral and maxillofacial surgeons, and midwives under specific circumstances detailed in the General Preamble ().
When to Use
- Use X451 for the professional interpretation of a multislice MRI sequence of the abdomen when performed for diagnostic purposes.
- Use this code for standard diagnostic abdominal MRI imaging where the clinical objective is anatomical or pathological assessment, distinct from biopsy guidance.
Common Pitfalls
- Do not bill X451 when the MRI is utilized specifically for guidance during an organ biopsy procedure, as this is explicitly excluded per the Schedule.
- Avoid billing X451 in conjunction with other imaging codes if the service is part of a bundled protocol, as this may trigger audit flags for unbundling.
- Ensure the referral source is limited to physicians, nurse practitioners, or oral and maxillofacial surgeons as per GP111, or the claim will be rejected.
Billing Tips
- If providing urgent interpretation for an acute care hospital patient after hours, ensure you select the appropriate special visit premium (e.g., C104 or C110) rather than attempting to add a premium to X451 itself.
- Verify that your documentation clearly distinguishes the diagnostic intent of the MRI to prevent confusion with interventional or biopsy-guided procedures.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
All insured services must be documented in appropriate records. The Act requires that the record establish that: 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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