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G031
G031 – Prothrombin time
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Prothrombin time is a miscellaneous diagnostic laboratory test. As an insured service, it includes the common elements outlined on pages - of the Schedule of Benefits.
When to Use
- Use G031 when performing an urgent, point-of-care Prothrombin time test in the office or hospital setting that is not covered under the global laboratory requisition fee.
- Bill G031 when managing a patient on anticoagulation therapy where an immediate result is required to adjust dosage during an unscheduled visit.
Common Pitfalls
- Do not bill G031 for routine lab tests sent to an external community laboratory, as these are billed directly by the lab and not by the physician.
- Avoid billing G031 in conjunction with a comprehensive physical examination (A007/A008) if the test is considered part of the routine diagnostic workup included in the assessment fee.
Billing Tips
- G031 is eligible for payment in addition to an assessment fee, so ensure you bill both the visit code and the procedure code when the test is medically necessary during the encounter.
Provider Fee$6.40
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Laboratory
Code Classes
Diagnostic and Therapeutic Procedures
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