J065

PDF page 320 / A192

Consultation
       A diagnostic radiology consultation is the service rendered when:
      a. radiographs or ultrasounds made at one institution or facility are referred to a radiologist at a
          different institution or facility for his/her written opinion. In this case, the specific elements are
          as for diagnostic radiology professional component (see page D1);
      b. a radiologist is required to make a special visit at evening or night (17:00h to 07:00h) or on a
         Saturday, Sunday or holiday to consult on the advisability of performing a diagnostic
         radiological procedure which eventually is not done. In this case, the specific elements are
         the same as for consultations; or
      c. when a radiologist is required to render an opinion prior to an interventional procedure and
         all of the following requirements are met. In this case, the specific elements are the same as
         for consultations:
           i.   the consultation is performed in an area remote from the radiologist’s normal procedural
                suite;
           ii. the requirements for a consultation are met;
           iii. the consultation is not solely for the purpose of clarifying or obtaining consent; and
           iv. the associated procedure is one of the following: J021, J025, J040, J041, J046, J048,
               J049, J050, J055, J056, J057, J058, J059, J063, J065, J066, N107, N118, N122, N125,
               S233, Z446, Z456, Z562, Z594.
 A335 Consultation............................................................................                 57.90
       Payment rules:
       1.A diagnostic radiology consultation is not eligible for payment when radiographs made in a
         different institution or facility are used for comparison purposes with radiographs or
         ultrasounds made in the consultant’s institution or facility.
       2.A335 is not eligible for payment for CT and MRI services.
       [Commentary:
       For a second opinion by a radiologist of CT and MRI studies, see A330 and A332 respectively.]

PDF page 389 / E5

CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC
               RADIOLOGICAL EXAMINATIONS
 MISCELLANEOUS PROCEDURES
                                                                                                   Spec     Anae
     Lymphangiogram
# J010 - per side...............................................................................   114.90
# J037 Mammary ductography ...........................................................              76.75
# J011 Myelogram ..............................................................................    101.90    6
# J038   - with supine views requiring removal and re-introduction of
           spinal needle.............................................................. add          23.75
# J020   - with posterior fossa views .......................................... add                26.05
# J012 Nephrotomogram....................................................................            -       6
# J060 Nephrostogram .......................................................................        52.10
# J045      Percutaneous antegrade pyelogram.......................................                215.45    6
# J055      Percutaneous gastrostomy .....................................................         394.90
# J061      Percutaneous cecostomy .......................................................         394.90
# J062      Percutaneous cholecystostomy ..............................................            394.90
# J063      Percutaneous jejunostomy .....................................................         458.05
# J046 Percutaneous nephrostomy.................................................... 394.90      6
# J064 Exchange or replacement of drainage tube............................          99.90
      Payment rules:
      1.J064 is only eligible for payment when performed in an interventional radiology suite under
        fluoroscopic or other imaging guidance.
         2.J064 includes any image guidance, when rendered, by any physician. Obtaining and
           interpreting any images in conjunction with J064 are not eligible for payment to any
           physician.
      [Commentary:
      J064 includes exchange or replacement of nephrostomy tubes, cholecystectomy tubes, pleural
      drainage catheters, abscess drainage catheters, and biliary drainage catheters.]
# J041 Percutaneous removal of intravascular and intraureteric
           foreign bodies..................................................................... 521.05 IC
# J065 Dilation of non-vascular structures .........................................                36.15    6
# J059 Non-vascular stenting .............................................................         179.20
# J069 Percutaneous focal thermal ablation of solid tumours using CT
          or ultrasound guidance .......................................................           790.25
         Payment rules:
         1.J069 is only eligible for payment for focal thermal ablation of solid tumours in patients
           meeting clinical criteria consistent with current clinical practice guidelines
         2.J069 includes any image guidance, when rendered, by any physician. Obtaining and
           interpreting any images in conjunction with J069 are not eligible for payment to any
           physician.

Master, record 2543. Record Layout PDF, page 1.

J06520260401999999990000036150000000000000000000000000000095760000000957600

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.