Billing code
J163C — Limited pelvic ultrasound – other than pregnancy
Limited pelvic ultrasound, not pregnancy
Bill J163 for a limited pelvic ultrasound for a reason other than pregnancy.
Watch for: Not for pregnancy studies, and residual urine measurement (G900) isn't payable with it.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $0.00 | $37.30 | $17.55 | $17.55 |
- Code
- J163C
- Description
- Limited pelvic ultrasound – other than pregnancy
- 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
Limited pelvic ultrasound for a reason other than pregnancy.
What it covers
J163 is a limited pelvic ultrasound study for other than pregnancy (G6). The complete pelvic study is J162 (G6).
Billing rules
- Not for pregnancy; pregnancy studies are under the Pregnancy heading (G5–G6).
- Residual urine measurement by ultrasound (G900) is not payable with a pelvic or intracavitary ultrasound (G6, note 2).
- 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).
- Not insured when done to support in-vitro fertilization or artificial insemination (G2 commentary; G6 commentary).
Related codes: J162, J161, J138, J158
Source: Schedule of Benefits (July 1, 2026), Diagnostic Ultrasound, Pelvis, page G6.
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