J900

PDF page 341 / B3

NUCLEAR MEDICINE - IN VIVO
 CARDIOVASCULAR SYSTEM
                                                                                                           H      P
     Venography
   J802 - peripheral and superior vena cava .....................................                         96.35   45.85
     First Transit
   J804 - without blood pool images..................................................                     16.10   18.85
   J867 - with blood pool images.......................................................                   57.30   26.45
     Cardioangiography
   J806 - first pass for shunt detection, cardiac output and transit
           studies ................................................................................       95.10   47.45
     Myocardial Perfusion Scintigraphy
   J807 - resting, immediate post stress............................................                     217.55   38.10
   J900         - application of PET for myocardial perfusion (maximum 1
                  per examination), to J807 .......................................... add                43.50   23.65
   J808       - delayed...............................................................................    80.10   20.90
   J809       - application of SPECT to J807 or J808 ......................... add                        43.50   23.65
   J901       - application of Rubidium PET for cardiac perfusion
                (maximum 1 per examination), to J808 ........................ add                         43.50   23.65
         Payment rules:
         1.J809 is limited to a maximum of 1 service with J807 per examination and a maximum of 2
           services with J808 per examination.
         2.J900 and J901 are only eligible for payment 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. Please refer to the PET section of the Schedule of Benefits for more details
         3.J900 and J901 are not eligible for payment when performed for an indication listed as
           evidence-building on the PET Scans Ontario website including PET Registry and/or PET
           Access Program indications.
     Myocardial scintigraphy
   J810 - acute infarction, injury, inflammation, infiltration .................                          88.25   43.15
      Myocardial wall motion
   J811   - studies ................................................................................      95.10   43.25
   J812     - repeat same day (to a maximum of three repeats) ..........                                  48.15   20.90
   J813 - studies with ejection fraction ..............................................                  135.15   62.50
   J814 - repeat same day (to a maximum of three repeats) ............                       48.15 33.00
       Note:
       J811 and/or J812 rendered in conjunction with J813 and/or J814 are insured services payable
       at nil.
   J815 Detection of venous thrombosis using radioiodinated
             fibrinogen up to ten days .................................................... 131.70 45.85

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 2875. Record Layout PDF, page 1.

J90020260401999999990000000000000000505500000000000000000000000000000236500

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.