J006

PDF page 388 / E4

CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC
              RADIOLOGICAL EXAMINATIONS
MISCELLANEOUS PROCEDURES
                                                                                                                   Spec          Anae
# J001 Arthrogram, tenogram or bursogram ......................................       52.10        7
      Note:
      Biliary duct calculus manipulation etc. (see Z562 listed in Digestive System - Biliary Tract.)
    Bronchial brushing
# J024 - unilateral.............................................................................                    89.90          6
# J044 - bilateral...............................................................................                  135.00          6
    Bronchogram
# J002 - unilateral.............................................................................                     27.00         6
# J043 - bilateral...............................................................................                    40.65         6
    Bronchogram with intra-tracheal catheter
# J003 - unilateral.............................................................................                     68.00         6
# J042 - bilateral...............................................................................                    82.20         6
    Carotid or vertebral artery occlusion by detachable balloon
# J050 - percutaneous......................................................................                        297.30
# J053 Cavernosography ...................................................................                           45.35
# J005 Dacrocystogram......................................................................                          45.40         6
    Discogram
# J006 - one disc ..............................................................................                   105.30          7
# J030   - each additional disc ................................................... add                             54.05
    Embolization of spinal arteriovenous malformation
# J049 - percutaneous......................................................................                        670.10          6
# J036 Fistula or sinus injection .........................................................                          29.40
# J068 Hydrostatic/pneumatic reduction of intussusception...............                                             48.30         7
# J008 Hysterosalpingogram..............................................................                             56.70         6
# J004 Intramammary needling for localization under mammographic
          control.................................................................................                   76.75
# J009 Laryngogram...........................................................................                        33.50

PDF page 467 / J53

+ G369 B.C.G. inoculation, following tuberculin tests..........................                                         5.30
  + G370 Injection of bursa, or injection and/or aspiration of joint,
            ganglion or tendon sheath .................................................                                  20.25
    G371 - each additional bursa, joint, ganglion or tendon sheath, to a
            maximum of 5 ....................................................................                            19.90
    E542    - when performed outside hospital, to G370 ................ add                                              12.65
               G328 Aspiration of bursa or complex joint, with or without injection                                      39.80
               G329   - each additional bursa or complex joint, to a maximum of 2
                                                                                                                           20.25
               E542                           - when performed outside hospital, to G328 ................ add              12.65
               E446                           - peripheral joint injection using image guidance following a
                                                failed blind attempt, to G370 or G371 ........................ add         30.00
                                          Note:
                                          1.For the purpose of G328 and G329, a joint is defined as complex only if it is:
                                             a.a joint other than the knee; or
                                             b.a knee joint in which the anatomy is distorted by disseminated lupus erythaematosus,
                                               dermatomyositis, rheumatoid arthritis, Still's disease, ankylosing spondylitis or other
                                               seronegative spondyloarthropathies.
                                          2.E446 is only eligible for payment when injection of the joint must be repeated using any
                                            method of image guidance following a failed blind attempt(s) by the same or different
                                            physician. Professional and/or technical fees for obtaining and interpreting the images
                                            required for the purpose of guidance of the injection are not eligible for payment to any
                                            physician.
                                          Payment rules:
                                          1. G370, G371, G328 or G329 are not eligible for payment when rendered in conjunction with a
                                            surgical procedure involving the same site or area.
                                          2. Only one of G370, G371, G328 and G329 is eligible for payment for the same bursa, joint or
                                            complex joint.
                                          3. Aspiration and/or injection of the olecranon bursa is only eligible for payment as G370/G371.
                                          4. G328/G329 are not eligible for payment solely for injection of complex joint.
                                          5. G370, G371, G328, G329 are uninsured services for injection of intra-articular
                                            viscosupplementation agents.
                                          [Commentary:
                                          1.Use of intra-articular viscosupplementation agent for treatment of osteoarthritis is not
                                            supported by evidence. An example of a viscosupplementation agent is hyaluronic acid. See
                                            https://www.hqontario.ca/Portals/0/Documents/evidence/reports/rev_hylan_061705.pdf
                                          2.For percutaneous provocation vertebral discography, refer to J006 Discogram page E4.]
    G396 Injections of extensive keloids ................................................                                24.90
  # Z455 - under general anaesthesia.................................................                                    44.70      6

Master, record 2487. Record Layout PDF, page 1.

J00620260401999999990000105300000000000000000000000000000111720000001117200

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.