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G004
G004 – Occult blood
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Performs a laboratory test for the presence of occult blood. This service is classified as a simple office laboratory procedure and, as per , may be delegated to a trained employee in the physician's office under appropriate supervision.
When to Use
- Use G004 when performing an in-office fecal occult blood test (FOBT) as a diagnostic procedure for a symptomatic patient.
- Use G004 for routine screening if the patient is ineligible for provincial screening programs or if the test is performed as part of an acute clinical assessment.
Common Pitfalls
- Billing G004 in addition to W010 is a common audit trigger, as G004 is explicitly included in the monthly management fee.
- Submitting G004 for a test performed by an external laboratory is incorrect; this code is strictly for procedures performed within the physician's office.
Billing Tips
- Ensure the test is documented as a distinct procedure in the patient chart to justify the diagnostic fee separate from the office visit code.
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