e.g., J890) or by adding H plus P2 (second code listed e.g., J690). When coding the total benefit use suffix A; when coding the technical portion only, use suffix B; when coding the professional portion only use suffix C.

Code SLEEP STUDIES

H

P1

P2

J890/J690 Level 1 - Overnight sleep study with continuous monitoring of oxygen saturation, ECG, ventilation by plethysmography and additional monitoring to stage sleep (EEG, EOG, and sub-mental EMG) and with technician attendance during study period. P1 to also include physician attendance at set up, monitoring and interpretation (special visit premiums may not be claimed)

371.10

169.40

63.40

 J891/J691 Level 2 - Overnight sleep study with continuous monitoring of oxygen  saturation, ECG and ventilation by plethysmography and with technician attendance during study period. P1 to also include physician attendance at set up, monitoring and interpretation, (special visit premiums may not be claimed).

  232.10

  125.50

46.90

 J892/J692 Level 3 - Overnight sleep study with monitoring to stage sleep (EEG, EOG, sub-mental EMG) and continuous monitoring of ECG with technician in attendance during study period. P1 to also include physician attendance at set up, monitoring and interpretation (special visit premiums may not be claimed).

189.30

  125.50

46.90

J893 Multiple Sleep Latency Test

  69.00

  48.30

0.00

As indicated in bulletin 4308 dated April 3, 1998, only operators of facilities providing sleep study services on and before April 3, 1998 will be eligible to apply for a licence under the grandfather clause of the Independent Health Facilities Act. The Ministry will forward IHF application forms to eligible operators based on billing data in the OHIP claims payment system. Applications will be forwarded following the July 1, 1998 change to the Schedule of Benefits.

Facility operators have one year to submit their licensing application. During this one-year period claims will continue to be submitted to OHIP in the current manner (with the new fee schedule codes noted above). Any inquiries regarding IHF licensing should be directed to Accountability Management Branch, Provider Payment Programs, Facility Payment and Policy at (613) 547-6637 (Kingston).

 J. Threshold Fee Reductions
As announced in Bulletin 4309, technical fees will be subject to the first level of threshold reductions. When the "Total Amount Payable" (which does not include any of the codes listed in Appendix E) reaches or exceeds the first threshold level, associated technical payments to a physician for services not rendered in a hospital or an independent health facility will be reduced by one-third. The technical fee reduction will remain at one-third even if the "Total Amount Payable" for other fees passes subsequent threshold levels.

2. OTHER CHANGES

K. Extended Certificate Registered Nurses (ECRNs)
Certain diagnostic procedures may be referred by an ECRN. Criteria for additional views are specified. Preamble to Diagnostic Radiology is amended to include the following paragraphs:

  1. If insured diagnostic radiology procedures yield abnormal findings or if they would yield information which in the opinion of the radiologist would be insufficient governed by the needs of the patient and the requirements of the referring physician or practitioner the radiologist may add further views and claim for them (if listed).
  1. Mammography or X-ray of the chest, ribs, arm, wrist, hand, leg, ankle or foot, rendered in an independent health facility or a hospital out-patient department, is insured when referred by a registered nurse holding an extended certificate of registration.

The following are added to Preamble to Diagnostic Ultrasound page G2, "Other Terms and Definitions":

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