J715

PDF page 352 / B14

POSITRON EMISSION TOMOGRAPHY (PET)
                                                                                                                               P
                                          Note:
                                          1.PET scanning is an insured service only when performed for an indication listed as an
                                            approved “Routine PET Scan” on the PET Scans Ontario website on the date that the service
                                            was rendered.
                                          2.PET scanning is not an insured service when performed for an indication listed as evidence-
                                            building on the PET Scans Ontario website (including PET Registry and/or PET Access
                                            Program indications) on the date that the service was rendered.
                                          3.PET scanning for all oncologic or suspected oncologic indications must be performed using a
                                            combined PET-computed tomography scanner (PET/CT) or combined PET-magnetic
                                            resonance imaging scanner (PET/MR) to provide attenuation correction and anatomic
                                            localization.
                                          4.Interpretation of CT or MR imaging performed as part of a PET /CT or PET/MR study for
                                            attenuation correction and anatomic localization is not eligible for payment.
                                          [Commentary:
                                          1.Current PET imaging recommendations/guidelines and lists of approved routine and
                                            evidence-building indications can be found at the following link: https://ontariohealth.ca/
                                            clinical/pet-scans
                                          2.PET scans may be available for uninsured indications through PET Scans Ontario Program,
                                            where evidence is being built in the province (Evidence-Building PET services). PET Scans
                                            Ontario is coordinated by Ontario Health. Additional information regarding Evidence-Building
                                            PET services may be found at the link provided above.]
               J715 PET – Cardiology, excluding myocardial perfusion ................                    237.50
               J714 PET – Oncology...................................................................... 290.50
               J716 PET – Neurology .................................................................... 290.50
               J717 PET – Infection and/or inflammation, excluding cardiac.........                      290.50
                   Payment rules:
                   1.Only one of J714, J715, J716 or J717 is eligible for payment per patient per day.
                                          2.J715 is not eligible for payment for assessment of myocardial perfusion using PET. See J900/
                                            J901 for further information.
                                          3.J717 is not eligible for payment for cardiac-related infection and/or inflammation indications.
                                          [Commentary:
                                          Where the primary purpose of the PET scan is to investigate cardiac-related infection or
                                          inflammation, J715 should be claimed.]

Master, record 2782. Record Layout PDF, page 1.

J71520260401999999990000000000000000000000000000000000000237500000002375000

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.