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G197

G197Skin testing - professional component

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

The professional component for allergy skin testing. The corresponding technical component is billed under G209. There is a maximum of 50 tests per year per patient.

When to Use

  • Use G197 when you are personally interpreting and documenting the results of allergy skin tests performed by staff.
  • Apply this code for each individual allergen test interpreted, ensuring the total count does not exceed 50 per patient per year.

Common Pitfalls

  • Billing G197 without a corresponding G209 claim for the technical component will trigger an audit flag for incomplete service reporting.
  • Submitting claims for more than 50 tests per patient per year will result in automatic rejection by the Ministry.
  • Attempting to bill G197 as a standalone service without documented clinical interpretation of the specific allergen reactions is a common cause of recovery.

Billing Tips

  • Always bill G197 in conjunction with G209 for every test performed to ensure the full professional and technical service is captured.
  • Maintain a log of the specific allergens tested to justify the count of G197 units billed if requested during a post-payment review.
Provider Fee$0.39

Effective: April 1, 2026

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

Diagnostic

Code Classes

Diagnostic and Therapeutic Procedures

professional component, to a maximum of 50 per year per test

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