G174 – Dobutamine stress test - technical component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This code represents the technical component of a Dobutamine stress test. A Dobutamine stress test uses medication to simulate the effects of exercise on the heart and is monitored via ECG. It is typically performed on patients unable to undergo a standard exercise stress test. Location-Specific Rules: - In-Hospital: When rendered in a hospital, this service is identified as G174A and the technical component is paid at 86.10% of the listed fee (see ). - Out-of-Hospital: The listing on page describes this service as 'technical component, when rendered outside of hospital'. Medical Necessity: This service is considered an uninsured service for routine annual stress tests in asymptomatic patients with a 10-year coronary heart disease risk of less than 10%. See Notes section for details.
When to Use
- Use G174 when performing the technical component of a pharmacological stress test for patients physically unable to achieve target heart rate on a treadmill or bicycle ergometer.
- Use G174 in conjunction with the appropriate professional fee code when the patient has a clinical indication for stress testing, such as unexplained exertional dyspnea or suspected ischemia, rather than for routine screening.
Common Pitfalls
- Billing G174 for asymptomatic patients with a 10-year coronary heart disease risk under 10% will result in a rejection or audit recovery as these are explicitly uninsured services.
- Failing to distinguish between G174 (out-of-hospital) and G174A (in-hospital) will cause payment discrepancies due to the 86.10% fee adjustment applied to the hospital-based technical component.
- Submitting G174 for routine preoperative cardiac clearance in low-risk surgical patients is a common cause for claim denial under the specific exclusions listed in the Schedule of Benefits.
Billing Tips
- Ensure the clinical indication for the test is clearly documented in the patient record to justify the medical necessity over the uninsured screening criteria.
- Verify the facility setting before submission to ensure the correct suffix (A) is applied to avoid the 13.9% payment reduction error for hospital-based services.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
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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