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X495
X495 – Repeat MRI - intermediate spine
OHIP Laboratory Code — MAGNETIC RESONANCE IMAGING (MRI) · Schedule of Benefits
A repeat Magnetic Resonance Imaging (MRI) scan for two adjoining spinal segments, performed as an addition to the initial multislice sequence (X493). This service involves acquiring images in another plane or using a different pulse sequence. Payment is limited to a maximum of three repeats per examination.
When to Use
- Use X495 when you must acquire an additional plane or pulse sequence for the same two spinal segments already covered by the initial X493 scan.
- Use this code for up to three distinct repeat sequences per examination to capture necessary diagnostic detail not provided by the initial multislice sequence.
Common Pitfalls
- Billing X495 more than three times per examination will trigger automatic rejections, as the schedule strictly limits this code to a maximum of three repeats.
- Attempting to use X495 for a different anatomical region or a separate spinal segment is incorrect; it is only valid as an add-on to the initial X493 sequence for the same segments.
Billing Tips
- Ensure your clinical notes clearly specify the additional plane or pulse sequence performed to justify each instance of X495 billed.
- Always link X495 to the primary X493 claim, as it is an add-on service that requires the base procedure to be present for payment.
Provider Fee$0.00
Non-Anaesthetist Fee$34.15
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
repeat (another plane, different pulse sequence - maximum of 3 repeats)
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