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G050
G050 – Endobronchial ultrasound (EBUS) for guided biopsy of hilar and/or mediastinal lymph nodes
OHIP Diagnostic & Therapeutic Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
G050: Endobronchial ultrasound (EBUS), for guided biopsy of hilar and/or mediastinal lymph nodes. The '#' prefix on this code indicates that when performed in a hospital or an Integrated Community Health Services Centre (ICHSC), the premises, equipment, supplies, and personnel are funded by the facility and not billed separately by the physician. See page () for details.
When to Use
- Use G050 as the primary code when performing EBUS-guided biopsy of mediastinal or hilar lymph nodes for staging or diagnostic purposes.
- Use G050 when the procedure is performed in a hospital setting, noting that the '#' prefix confirms facility costs are covered by the hospital global budget.
Common Pitfalls
- Failing to append E837 when multiple lymph node stations are biopsied, as G050 only covers the primary procedure.
- Attempting to bill a consultation or assessment code on the same day as G050 without meeting the criteria for a separate, distinct clinical encounter.
- Exceeding the maximum of 3 units of E837, which will trigger an automatic rejection for any additional biopsy claims.
Billing Tips
- Always claim E837 for each additional lymph node station biopsied beyond the first, up to a maximum of 3 units, to ensure full procedural compensation.
- Ensure that if the procedure is performed after hours, you apply the appropriate E409 or E410 premium to the G050 fee, provided the procedure meets the non-elective or emergency delay criteria.
Provider Fee$203.05
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures, Respiratory Surgical Procedures
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