G111 – Dipyramidole Thallium stress test - technical component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service is the technical component of a dipyridamole thallium stress test. See G112 for the corresponding professional component. Per , the physician claiming the technical component must have the necessary training and experience, and maintain documentation of quality assurance processes.
When to Use
- Use G111 for the technical component when performing a pharmacological stress test using dipyridamole in symptomatic patients who cannot achieve an adequate workload for a standard exercise stress test.
- Use this code for patients with a 10-year coronary heart disease risk of 10% or greater, as calculated by the Framingham Risk Score or similar validated tools, when they are asymptomatic.
Common Pitfalls
- Billing G111 for routine preoperative cardiac screening in patients undergoing low-risk procedures, which is explicitly excluded and subject to recovery upon audit.
- Failing to maintain the required quality assurance documentation for the technical equipment and process, which is a mandatory requirement under GP11 for claiming this technical fee.
- Billing G111 for asymptomatic patients with a 10-year coronary heart disease risk below 10%, as these are considered uninsured services.
Billing Tips
- Ensure you are also billing G112 for the professional component to complete the claim, as G111 only covers the technical portion of the procedure.
- If the service is performed within a hospital setting, remember that the payment is adjusted to 86.10% of the listed fee as per the rules in GP11.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
1. The technical and professional fee components for maximal stress ECG are not eligible for payment in the routine preoperative preparation or screening of a patient for surgery where the patient will undergo a low risk procedure or has a low risk of perioperative cardiac complications, unless there is a clinical indication requiring a exercise stress test study other than solely for preoperative preparation of the patient.
2. G315, G319, G174, G111 and G112 are uninsured services for routine annual stress tests in asymptomatic patients where the patient's 10 year risk of coronary heart disease is less than 10% calculated by generally accepted methodology.
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