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G278
G278 – Therapeutic plasma exchange - more than 5 per year
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
When to Use
- Use G278 for the sixth and any subsequent therapeutic plasma exchange sessions performed on the same patient within a rolling 12-month period.
- Apply this code for patients undergoing chronic maintenance plasma exchange therapy where the initial five sessions covered by G277 have already been exhausted.
Common Pitfalls
- Billing G278 before the fifth G277 claim has been processed will result in an automatic rejection for exceeding the annual limit of the base code.
- Failure to track the rolling 12-month window accurately often leads to audit recovery if G278 is billed prematurely in a new calendar year.
Billing Tips
- Ensure your EMR tracks the cumulative count of G277 and G278 claims per patient to trigger the switch from G277 to G278 automatically after the fifth session.
- You may append eligible Special Visit Premiums to G278 if the service is performed in an emergency or hospital setting outside of regular hours.
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