G166 – Hydrogen breath test - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service is for the professional component of a hydrogen breath test, which includes the physician's interpretation of the results and the preparation of a report. It is typically billed in conjunction with the technical component, G167, which covers the actual performance of the test. The professional component fee includes the skill, time, and responsibility involved in interpreting the data obtained from the hydrogen breath test to provide a diagnosis or medical opinion. The 'professional component' is a class of service listed in the Schedule headed by a column listed “P” or with 'professional component' listed opposite the service. Additional information including the requirements for performing the professional component is found in the individual preambles to the applicable sections of the Schedule.
When to Use
- Use G166 when you have provided a formal written interpretation and report for a hydrogen breath test performed in a facility setting.
- Bill G166 in conjunction with G167 when you are the physician responsible for both the technical supervision and the professional interpretation of the breath test results.
Common Pitfalls
- Billing G166 without a corresponding, dated, and signed interpretation report in the patient's medical record is a primary audit risk.
- Attempting to bill G166 for a test performed in a non-hospital or non-facility setting where the technical component G167 is not applicable or not billed.
Billing Tips
- Ensure the referring physician's name and billing number are clearly documented to satisfy the referral requirement mandated by GP111.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
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