X490 – Limited spine multislice sequence
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
X490 represents a multislice sequence Magnetic Resonance Imaging (MRI) procedure for a limited (one segment) area of the spine. For additional imaging of the same area in a different plane or with a different pulse sequence, see X492. This service may be eligible for premiums such as X486 for cardiac gating or X487 for the use of gadolinium.
When to Use
- Use X490 as the primary code for the initial multislice sequence of a single spinal segment (e.g., cervical, thoracic, or lumbar).
- Use X490 when performing the first sequence of a limited area study before billing subsequent planes or sequences using X492.
Common Pitfalls
- Billing X490 multiple times for additional planes or pulse sequences of the same segment instead of using the designated repeat code X492.
- Failing to document the specific spinal segment imaged, which is required to justify the 'limited' scope of the X490 service.
Billing Tips
- Always bill X490 as the base service and append X492 for up to three additional sequences performed during the same sitting to ensure correct reimbursement for the full examination.
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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