L223 SGPT (ALT)

10

5

L225 Automated chemical analyzers with simultaneously functioning channels

18

5

L226 Sodium

6

5

L243 Triglycerides

10

5

L251 Urea nitrogen (BUN)

6

5

L252 Uric acid

6

5

L306 Digoxin

40

28

L315 FSH

50

28

L319 Hepatitis associated antibody or antigen

35

28

L321 Aminophylline (Theophylline)

40

28

L328 LH (luteinizing hormone)

50

28

L329 Ferritin

40

28

L331 Progesterone

40

28

L332 Prolactin

55

28

L334 IgE

40

28

L340 Testosterone

40

28

L341 TSH

40

28

L345 Vitamin B12

40

28

L607 Free T3

30

28

L919 Hepatitis - secondary laboratory

35

28

D. CHANGES TO THE MEDICAL RULES

The description in Paragraph 14 of the old Schedule is deleted. Instead, the maximum number of units that can be claimed for L393 (Complete Blood Count) is 16 units per patient per day. The individual codes L372, L396, L397, L399, L417 and L418 should not be used. However, all six (6) test values must be reported regardless of which test(s) is (are) ordered.

The maximum number of units referred to in Paragraph 15 in the old Schedule has been deleted for any combination of the tests represented by the following codes: L005, L030, L045, L053, L061, L067, L111, L191, L194, L204, L208, L222, L223, L225, L226, L251, and L252.

The maximum number of units for L225 (Automated chemical analyzer with simultaneously functioning channels) is 5 units per patient per day.

The maximum number of units for any combination of L055 (cholesterol), L153 (lipoprotein, electrophoresis) and L243 (triglycerides) is 30 units per patient per day.

SYSTEM CHANGES

System changes have been made to the Medical Claims Payment system for claims submission effective April 1, 1999.

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Ontario Ministry of Health and Long-Term Care
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