G205 – Insect venom desensitisation (immunotherapy)
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G205 is the fee for a single injection for insect venom desensitisation (immunotherapy). Usage Limit: A maximum of 5 injections may be claimed per patient per day. Billing with Assessments: After the patient's initial major assessment for the condition has been performed, a minor or partial assessment may be claimed once per day in addition to G205, if rendered. Billing with Counselling: G205 is eligible for payment when rendered on the same day as counselling services (see page of the Schedule).
When to Use
- Use G205 for the administration of venom immunotherapy injections when the patient is in the maintenance phase of desensitization.
- Use G205 in conjunction with a minor or partial assessment code when a patient presents for an injection and requires a brief evaluation of their allergic status post-initial major assessment.
- Use G205 when a patient presents for an injection but also requires an assessment for an unrelated acute condition, such as a respiratory infection, allowing for both the procedure and the assessment fee.
Common Pitfalls
- Claiming G205 more than 5 times per patient per day will trigger an automatic rejection from the Ministry.
- Attempting to bill a major assessment code (e.g., A007) alongside G205 on the same day is often flagged; ensure the major assessment is only billed once at the start of the treatment series.
- Failing to document the specific elements of the assessment when billing a minor or partial assessment alongside G205 can lead to recovery during an audit.
Billing Tips
- Always bill G205 with the appropriate assessment code if you are evaluating the patient's reaction to the previous dose, as the injection fee alone does not capture the cognitive work of the assessment.
- You may stack G205 with counselling codes like K013 or K033 on the same day, provided the counselling service meets the time and documentation requirements independent of the injection procedure.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
If a patient presents for an allergy injection and has an acute infectious condition, albeit of the respiratory system, or some other unrelated condition which would have otherwise required a separate office visit, the physician is entitled to claim the appropriate assessment fee as well as the injection fee.
If a patient requires a brief assessment of his allergic condition as well as the allergy injection, the physician should claim the injection and the basic fee, in which case the specific elements of the service include those of an assessment (see General Preamble ).
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