X493 – Multislice sequence - intermediate spine
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
Magnetic Resonance Imaging (MRI) of an intermediate spine, defined as two adjoining segments, utilizing a multislice sequence. This is the initial or base scan for this region. This service may be followed by repeat scans using X495 for another plane or a different pulse sequence. [Commentary from ]: For diagnostic services with both technical and professional components listed under one fee schedule code, the components are claimed separately. The claim for the technical component is submitted using the fee schedule code with suffix B, and the claim for the professional component is submitted using the fee schedule code with suffix C.
When to Use
- Use X493 as the base code for an MRI examination covering two adjoining spinal segments, such as cervical-thoracic or thoracolumbar junctions.
- Use this code for the initial multislice sequence acquisition before adding any subsequent plane or pulse sequence repeats.
Common Pitfalls
- Failing to split the claim into technical (suffix B) and professional (suffix C) components, which is mandatory for this code per GP11.
- Attempting to bill X493 for single-segment spinal imaging, which may be subject to audit if the clinical documentation does not clearly define the two adjoining segments scanned.
- Over-claiming X495 repeats beyond the maximum of three allowed per examination.
Billing Tips
- Ensure the technical component (X493B) and professional component (X493C) are submitted as separate claims to avoid automatic rejection.
- Always append X495 for additional planes or pulse sequences to maximize the total fee for the examination, provided the maximum of three repeats is not exceeded.
Effective: April 1, 2025
F. Magnetic Resonance Imaging (MRI)
MAGNETIC RESONANCE IMAGING (MRI)
Diagnostic
Magnetic Resonance Imaging (MRI)
As per , all insured services must be documented in the patient's medical record to 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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