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G185
G185 – Drug(s) desensitisation
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Drug(s) desensitisation - in a hospital where full cardioresuscitative equipment is readily available because a significant risk of life-threatening anaphylaxis exists. The service must be performed under direct and ongoing physician attendance.
When to Use
- Use G185 for the active, physician-supervised administration of escalating doses of a medication to a patient with a documented history of severe hypersensitivity, such as chemotherapy or antibiotic desensitization.
- Select G185 when the procedure is performed in a hospital setting where immediate access to crash carts and resuscitation equipment is mandatory due to the high probability of anaphylaxis.
Common Pitfalls
- Billing G185 for routine drug administration or standard allergy injections that do not meet the high-risk criteria for anaphylaxis, which should instead be billed under standard office visit or injection codes.
- Failing to document continuous physician presence, as G185 is a time-intensive procedure that requires the physician to be in the room or immediately available throughout the entire desensitization process.
- Attempting to bill G185 in a non-hospital setting, as the code specifically requires the availability of hospital-grade cardioresuscitative equipment.
Billing Tips
- Ensure you append the appropriate Special Visit Premium (Table II or III) if the service is performed outside of standard hospital clinic hours, as G185 is eligible for these add-ons.
- If the desensitization requires multiple stages or prolonged monitoring beyond the initial procedure, ensure the chart clearly reflects the ongoing physician attendance to justify the claim during an audit.
Provider Fee$184.95
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
The medical record must reflect that the service was performed under direct and ongoing physician attendance.
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