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G196

G196Hypersensitivity skin test for validated drugs or agents

OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

Performs a hypersensitivity skin test for validated drugs or agents. This test explicitly excludes testing for foods and inhalants. The add-on code E582 may be claimed in addition to G196 when testing with penicillin minor determinant mixture is performed outside a hospital setting.

When to Use

  • Use G196 when performing a diagnostic skin prick or intradermal test specifically to confirm or rule out a drug hypersensitivity reaction.
  • Select G196 for testing validated pharmaceutical agents, such as local anesthetics or antibiotics, where the clinical suspicion of an IgE-mediated reaction exists.

Common Pitfalls

  • Claiming G196 for allergy testing related to environmental inhalants or food allergens, which are explicitly excluded from this code's scope.
  • Billing E582 in conjunction with G196 for hospital-based procedures, as E582 is strictly limited to non-hospital settings.

Billing Tips

  • Ensure the specific drug agent tested is clearly identified in the medical record to support the diagnostic nature of the G196 claim during an audit.
  • Always append E582 to your G196 claim when testing with penicillin minor determinant mixture in a community clinic to capture the additional $32.20 fee.
Provider Fee$17.00

Effective: April 1, 2025

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

Procedure

Code Classes

Diagnostic and Therapeutic Procedures

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