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G041
G041 – Target drug testing, urine, qualitative or quantitative
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G041 is a point of care laboratory test for a specific drug of abuse, performed on a urine sample. It can be either qualitative or quantitative. This service is subject to several payment rules, including physician eligibility for opioid agonist treatment, co-billing requirements with an assessment, and monthly frequency limits that vary based on other services provided to the patient. It is considered a delegatable procedure under the Schedule as described in .
When to Use
- Use G041 when performing a point-of-care urine drug screen for a specific substance in a patient enrolled in your opioid agonist treatment program.
- Use G041 during a scheduled chronic pain management visit where you have already billed a K682 or K683 to monitor for compliance with a prescribed opioid regimen.
Common Pitfalls
- Billing G041 without an associated K623, K624, or a physical assessment code in the same month will result in a rejection.
- Exceeding the monthly limit of three services when K682 or K683 is not billed, or five services when they are, will trigger automatic payment adjustments.
- Attempting to bill G041 alongside G040, G042, or G043 for the same urine sample is prohibited and will lead to claim rejection.
Billing Tips
- Ensure your Section 56 exemption is active and on file with the Ministry, as G041 eligibility is strictly tied to this credential for addiction and chronic pain management.
- Always link the G041 to a qualifying assessment or time-based service in your billing software to satisfy the monthly encounter requirement.
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