X471 – Multislice sequence, one extremity and/or one joint
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
This service covers the professional component of a magnetic resonance imaging (MRI) multislice sequence for one extremity and/or one joint. For the purpose of this service, eligible joints are defined as the shoulder, elbow, wrist, hip, knee, and ankle as per Note 3 on page of the Schedule. A repeat scan using X475 may be claimed for another plane or a different pulse sequence, up to a maximum of 3 repeats.
When to Use
- Use X471 as the primary code for the initial multislice MRI sequence of a single eligible joint (shoulder, elbow, wrist, hip, knee, or ankle).
- Use X471 when performing the first diagnostic scan of an extremity or joint before determining if additional planes or pulse sequences (billed as X475) are required.
Common Pitfalls
- Billing X471 multiple times for the same joint in a single session instead of utilizing X475 for subsequent planes or pulse sequences.
- Attempting to claim X471 for body parts not explicitly defined as eligible joints, such as the spine or small joints like fingers and toes, which fall under different codes.
- Failing to ensure the referral source is an eligible provider type, which will result in an automatic rejection of the claim.
Billing Tips
- You may claim up to three repeats of X475 in addition to the initial X471 if the clinical protocol requires multiple planes or pulse sequences for a single joint.
- Ensure that the diagnostic urgency and setting meet the criteria for C109 or C104 if you are attempting to append these premiums to the X471 professional component.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
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