X461 – Multislice sequence
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
Magnetic Resonance Imaging (MRI) of the pelvis utilizing a multislice sequence. This service can be billed with X486 for cardiac gating (add 30%) or X487 if gadolinium is used (add $36.65). The repeat scan, X465, is for an additional plane or different pulse sequence and is limited to a maximum of 3 repeats. As per , this service is insured when referred by a physician, a nurse practitioner, or an oral and maxillofacial surgeon under specific conditions.
When to Use
- Use X461 as the primary code for the initial pelvic MRI sequence when imaging the pelvic floor, prostate, or gynecological structures.
- Apply X461 when the clinical requirement necessitates a standard multislice sequence that does not fall under specialized regional MRI codes.
Common Pitfalls
- Billing X461 in combination with X465 more than three times per patient per day will trigger an automatic rejection.
- Failing to append X487 when contrast is administered results in the loss of the $36.65 add-on fee for gadolinium.
Billing Tips
- Always verify if cardiac gating (X486) is clinically justified and documented to secure the 30% fee increase on the base X461 rate.
- Ensure X465 is only used for additional planes or distinct pulse sequences performed after the primary X461 sequence to avoid audit flags for duplicate billing.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
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