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Billing code

J160C — Complete pregnancy ultrasound – high risk or complications

Complete high-risk pregnancy ultrasound

Bill J160 for a complete pregnancy ultrasound in a high-risk pregnancy or one with complications.

Watch for: Add J166 for each extra fetus; not payable the same day, same patient, as a J168 nuchal translucency scan.

Code

J160C

Description

Complete pregnancy ultrasound – high risk or complications

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 for a high-risk pregnancy or complications of pregnancy.

What it covers

J160 is a complete pregnancy ultrasound for a high-risk pregnancy or complications of pregnancy (G5). Each additional fetus in a multiple gestation is J166 (G5).

Billing rules

• Add J166 for each additional fetus in a multiple gestation (G5).
• Add J167 (fetal Doppler of the middle cerebral artery and/or ductus venosus) only for assessment of fetal anemia, IUGR (estimated fetal weight or abdominal circumference below the 10th percentile, or a ≥30 percentile drop since previous imaging), or high-risk pregnancies (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).

Often billed with

• J166 for each additional fetus (G5).
• J167 fetal Doppler when its criteria are met (G5).

Related codes: J158, J166, J167, J159, J168

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

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