G025 – Dehydroepiandrosterone sulphate (DHEAS)
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Dehydroepiandrosterone sulphate (DHEAS) is an insured laboratory service when rendered by a physician in their own office for their own patient. According to the notes on , this test is only payable to physicians for whom point of care testing is necessary for their practice, such as in reproductive medicine. The service is not insured when rendered to support in-vitro fertilization or artificial insemination services. Payment requires that the test result, physician's interpretation, and the treatment decision be documented in the patient's permanent medical record.
When to Use
- Use G025 when performing point-of-care DHEAS testing to investigate hyperandrogenism or adrenal pathology in a clinical setting where immediate results are required for patient management.
- Use this code specifically for diagnostic purposes in reproductive endocrinology, provided the testing is not associated with IVF or artificial insemination cycles.
Common Pitfalls
- Billing G025 for tests performed to support IVF or artificial insemination procedures will result in automatic rejection or clawback as these are explicitly excluded under J65.
- Failure to document the specific test result, your clinical interpretation, and the resulting treatment plan in the patient's chart will lead to audit failure and recovery of funds.
- Billing G025 as a general screening tool without a clear clinical indication for point-of-care necessity is a common cause for claim rejection.
Billing Tips
- Ensure your practice profile supports the necessity of point-of-care testing, as the Ministry restricts payment of G025 to physicians for whom such testing is integral to their specific scope of practice.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Laboratory
Diagnostic and Therapeutic Procedures
Laboratory services are only eligible for payment if the result of the test(s), the physician's interpretation of the results of the test(s) and the treatment decision based on the test results are documented in the patient's permanent medical record.
Tests listed under “Reproductive medicine” and “Point of care drug testing” are only payable to those physicians where point of care testing is necessary for their practice.
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