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E430

E430Collection of cervical cancer screening specimen(s) - outside of hospital or ICHSC

OHIP Surgical Assists Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

This is an add-on premium payable in addition to G365 for the collection of cervical cancer screening specimen(s). It applies when the service is rendered in a setting outside of a hospital or an Integrated Community Health Services Centre (ICHSC).

When to Use

  • Use E430 as an add-on to G365 when performing a routine cervical cancer screening (Pap test) in a community clinic or private office setting.
  • Apply this code specifically for patients aged 21 to 24 who are eligible for screening according to the current Ontario cervical cancer screening guidelines.

Common Pitfalls

  • Billing E430 for patients outside the <25 age restriction will result in an automatic rejection.
  • Attempting to claim E430 alongside W010 is a common audit trigger, as the collection fee is already bundled into the nursing home monthly management fee.
  • Submitting E430 without an associated G365 claim will cause the premium to be rejected as an orphan code.

Billing Tips

  • Always link E430 to the G365 service date to ensure the system recognizes the premium as an add-on to the primary procedure.
Provider Fee$11.95

Effective: April 1, 2025

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

Premium

Code Classes

Other Premiums (including After Hours Procedure Premiums), Diagnostic and Therapeutic Procedures

Age Restriction

<25

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