< Billing codes

Billing code

J159C — Complete pregnancy ultrasound – 16 weeks or later

Complete pregnancy ultrasound

Bill J159 for a complete pregnancy ultrasound at or after 16 weeks in a normal pregnancy.

Watch for: Maximum one per normal pregnancy; for a high-risk pregnancy or complications, bill J160 instead.

Code

J159C

Description

Complete pregnancy ultrasound – 16 weeks or later

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Complete pregnancy ultrasound at or after 16 weeks' gestation. Maximum one per normal pregnancy.

What it covers

J159 is a complete pregnancy ultrasound on or after 16 weeks' gestation (G5). For a high-risk pregnancy or complications of pregnancy, the complete study is J160 (G5).

Billing rules

• On or after 16 weeks' gestation (G5).
• Maximum one per normal pregnancy (G5).
• Abdominal, pelvic or pregnancy ultrasounds on the same day, same patient, by any physician as a J168 nuchal translucency scan are not payable (G5).
• Bill the technical component (H column) with suffix B and the professional component (P column) with suffix C (G2, rule 1).
• The technical component is payable only at a hospital or a hospital's approved off-site premises; outside hospital, only the professional component (suffix C) is billable to OHIP (G1; G2, rule 2).
• The technical component isn't payable for in-patients, or when the patient is admitted to the same hospital within 24 hours for the same condition (GP11).
• The physician claiming the professional component must personally interpret the study (G1, note 1).
• Pregnancy ultrasound is insured when referred by a midwife, in an ICHSC or hospital (GP111).

Common rejections

• AM1: 'Service limit exceeded': J159 was already paid in this normal pregnancy (G5).

Related codes: J160, J166, J157, J158, J168

Source: Schedule of Benefits (July 1, 2026), Diagnostic Ultrasound, Pregnancy, page G5.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing