X489 – Repeat MRI sequence
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
Repeat Magnetic Resonance Imaging (MRI) for two or more extremities, and/or two or more joints on the same extremity, performed during the same session as the initial multislice sequence scan (X488). This repeat scan utilizes a different plane or pulse sequence. Up to 3 repeats are allowed per session. Specific requirements include separate surface coil, imaging sequence, filming, and post-processing for each joint examined. Eligible joints include the shoulder, elbow, wrist, hip, knee, and ankle.
When to Use
- Use X489 to bill for the second or third joint scanned in a single session when the primary joint was billed under X488.
- Use X489 when imaging two or more distinct joints on the same extremity (e.g., knee and ankle) during one MRI session, provided each joint requires a separate surface coil and sequence.
- Use X489 when imaging bilateral joints (e.g., bilateral hips or bilateral knees) in the same session, with X488 covering the first joint and X489 covering the subsequent joint(s).
Common Pitfalls
- Billing X489 as a standalone code; it is strictly an add-on and must be submitted in conjunction with X488.
- Exceeding the lifetime limit of 3 repeats per patient, which will result in automatic claim rejection.
- Failing to document the use of separate surface coils, distinct imaging sequences, and independent post-processing for each joint, which is a mandatory audit requirement.
Billing Tips
- Ensure the claim includes the specific anatomical sites for both the X488 and X489 components to justify the multiple joint imaging.
- Apply relevant age-based diagnostic premiums to X489 if the patient qualifies, as these are calculated based on the fee of the procedure code itself.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
Requires separate surface coil, separate imaging sequence, separate filming and separate post-processing for each joint examined.
X488 and X489 require imaging of two extremities or two or more joints in the same extremity during the same examination at one sitting.
X488 and X489 requires separate surface coil, separate imaging sequence, separate filming and separate post-processing for each joint examined.
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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