G138 – Professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Professional component for an evoked potentials test performed on the upper or lower limbs. This service represents the physician's work in interpreting the results of the test. The technical component is billed separately as G140. When only one limb is tested, this service must be claimed at 50% of the listed fee.
When to Use
- Use G138 when you are providing the formal physician interpretation and report for evoked potential studies performed on either upper or lower limbs.
- Use G138 in conjunction with G140 when you are billing for the professional component while the facility or clinic bills the technical component.
Common Pitfalls
- Failing to manually adjust the fee to 50% when only a single limb is tested, which leads to automatic claim rejections or audit flags.
- Billing G138 without ensuring that the corresponding G140 technical component has been performed and documented, as the professional component requires the existence of the technical study.
Billing Tips
- Always append the appropriate modifier or use the 50% fee reduction when testing only one limb to ensure compliance with the Schedule of Benefits.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The physician's interpretation and report must be documented in the patient's medical record.
The physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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