G254 – Management of post liver, lung or pancreas transplant immunosuppression
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
The management of post liver, lung or pancreas transplant immunosuppression is a per-visit service for hospital in-patients, intended as a substitute for non-emergency hospital visits. Payment for this service is subject to specific limitations: it cannot be billed with other subsequent hospital visits or assessments, is restricted to in-patients only, can be claimed once per day per patient, and is only available for the first two weeks following the transplant surgery.
When to Use
- Use G254 for daily inpatient rounding specifically focused on immunosuppression management during the critical 14-day window post-transplant.
- Select G254 instead of a standard subsequent visit code (C002) when the primary clinical focus is the adjustment of antirejection medication regimens.
Common Pitfalls
- Billing G254 beyond the 14-day post-operative period will trigger an automatic rejection; switch to standard subsequent visit codes (C002) thereafter.
- Attempting to bill G254 in conjunction with any other hospital assessment or consultation code for the same patient on the same day will result in a claim denial.
- Submitting G254 for outpatient clinic follow-ups is an audit risk, as the code is strictly restricted to hospital inpatients.
Billing Tips
- Ensure your documentation explicitly highlights the immunosuppression management component to justify the use of this specific fee over a standard subsequent visit.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
ManagementFee
Diagnostic and Therapeutic Procedures
G254 is not eligible for payment in addition to a subsequent hospital visit or assessment.
G254 is not eligible for payment when rendered to an out-patient.
G254 is limited to a maximum of one service per patient per day.
G254 is only eligible for payment for a maximum of 2 weeks post liver, lung or pancreas transplant surgery.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.