J069

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.

PDF page 390 / E6

CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC
             RADIOLOGICAL EXAMINATIONS
MISCELLANEOUS PROCEDURES
                                                                                          Spec         Anae
      [Commentary:
      Physicians should consult Ontario Health/Cancer Care Ontario’s Focal Tumour Ablation in
      Ontario: Recommendations Report 2015 or subsequent guidelines to verify clinical indications
      for J069 https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/48981 ]
# J051 Percutaneous spinal cord puncture for syringogram ..............                166.95 6
# J013 Percutaneous trans-hepatic cholangiogram ...........................            185.90 6
# J057 Transjugular intrahepatic portosystemic shunt (TIPS) ............              1389.60 7
# J052 Positive contrast cisternogram................................................   99.90 6
  Z597  Intracavitary/intratumoural injections ......................................             159.05 7
# J039  Renal cyst puncture ................................................................      215.25 6
# J018  Sialogram................................................................................  80.10 6
# J007  Tomogram...............................................................................     -    7
# J028  Urethrogram and/or urethrocystogram and/or intestinal conduit
           examination, cystogram .....................................................            52.10
# J029 Vasogram................................................................................   105.80 6
      Note:
      Intubation of small intestine (see Z540 listed in Digestive System - Intestines (except rectum)).

PDF page 722 / T2

UROGENITAL AND URINARY SURGICAL PROCEDURES
KIDNEY AND UPPER URINARY TRACT
                                                                                                           Asst         Surg          Anae
# E752         - with repeat surgery on kidney at least 30 days after
                 previous kidney surgery ............................................. add                                83.25
    INCISION
# Z601 Renal biopsy, needle ..............................................................                              153.85          6
# S401 Drainage of renal or perirenal abscess...................................                              7         440.95          7
# S400 Laparoscopic placement of probe(s) for ablation of renal
         tumour ................................................................................              7         434.15          7
         Payment rules:
         This service is not eligible for payment in addition to J069.

Master, record 2547. Record Layout PDF, page 1.

J06920260401999999990000790250000000000000000000000000000000000000000000000

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.