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X471

X471Multislice 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.
Provider Fee$0.00
Non-Anaesthetist Fee$62.80

Effective: April 1, 2025

Category

F. Magnetic Resonance Imaging (MRI)

Subcategory

MAGNETIC RESONANCE IMAGING (MRI)

Service Type

Diagnostic

Code Classes

Magnetic Resonance Imaging (MRI)

Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon

For the purposes of X471, X475, X488 and X489, the following are considered eligible joints: shoulder, elbow, wrist, hip, knee and ankle.

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