G027 – Seminal fluid examination (complete)
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
A laboratory service (“test”) set out in this section is an insured service eligible for payment only when rendered by a physician (“the original physician”), or by a physician substituting for the original physician, who performs the test in the original physician's own office for the physician's own patient. This service is for the complete examination of seminal fluid. Tests listed under "Reproductive medicine” are only payable to those physicians where point of care testing is necessary for their practice.
When to Use
- Use G027 when performing a complete seminal fluid analysis in-office for diagnostic investigation of male factor infertility or post-vasectomy follow-up.
- Use this code only when the physician personally performs the analysis in their own office, rather than referring the specimen to an external laboratory.
Common Pitfalls
- Billing G027 for services related to in-vitro fertilization or artificial insemination is strictly prohibited and will result in claim rejection or audit recovery.
- Submitting G027 when the test is performed by an external laboratory or a licensed specimen collection centre is a violation of the 'original physician' requirement.
- Failing to document the specific test results and the subsequent clinical treatment decision in the patient record will lead to a full recovery of the fee during an audit.
Billing Tips
- Ensure the claim is only submitted if the test is medically necessary for your own patient and performed as point-of-care testing within your practice setting.
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.
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