< Billing codes

Billing code

J168C — Nuchal translucency ultrasound (prenatal genetic screening)

Nuchal translucency ultrasound

Bill J168 for a limited pregnancy ultrasound measuring nuchal translucency for prenatal genetic screening.

Watch for: Maximum one per pregnancy, and other abdominal, pelvic or pregnancy ultrasounds that day for the patient aren't payable.

Code

J168C

Description

Nuchal translucency ultrasound (prenatal genetic screening)

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 pregnancy ultrasound for nuchal translucency as part of prenatal genetic screening. Maximum one per pregnancy.

What it covers

J168 is a limited pregnancy ultrasound to measure nuchal translucency for Prenatal Genetic Screening (G5). Each additional fetus in a multiple gestation is J169 (G5).

Diagnostic ultrasound has a professional component (supervision, interpretation) and a technical component (performing the scan, the signed report to the referrer, premises and equipment) (G1).

Billing rules

• Maximum one per 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).

Often billed with

• J169 for each additional fetus (G5).

Common rejections

• AM1: 'Service limit exceeded': J168 was already paid in this pregnancy (G5).

Related codes: J169, J157, J158, J159, J160

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