G319 – Maximal stress ECG - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Professional component for a maximal stress ECG (exhaustion, symptoms or ECG changes) or submaximal stress ECG (to target heart rate for patient) by a standard technique - with treadmill or ergometer and oscilloscopic continuous monitoring including ECGs taken during the procedure and resting ECGs before and after the procedure - physician must be in attendance at all times. The professional component includes the necessary clinical assessment immediately prior to testing.
When to Use
- Use G319 when you are physically present for the entire duration of a maximal or submaximal treadmill/ergometer stress test to monitor for ischemia, arrhythmias, or hemodynamic instability.
- Use G319 for symptomatic patients (e.g., exertional chest pain or dyspnea) where the clinical goal is to provoke and document diagnostic ECG changes or symptoms.
Common Pitfalls
- Billing G319 for routine preoperative clearance in low-risk patients is a common audit trigger and is explicitly excluded by the Schedule of Benefits.
- Claiming G319 for asymptomatic screening in patients with a Framingham Risk Score under 10% will result in rejection or recovery as it is considered an uninsured service.
- Billing G319 without documenting your continuous attendance throughout the procedure, as the code specifically requires the physician to be in attendance at all times.
Billing Tips
- Ensure the clinical indication for the test is clearly documented in the patient chart to justify the procedure over G315, which is typically used for resting ECGs.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
1. The technical and professional fee components for maximal stress ECG are not eligible for payment in the routine preoperative preparation or screening of a patient for surgery where the patient will undergo a low risk procedure or has a low risk of perioperative cardiac complications, unless there is a clinical indication requiring a exercise stress test study other than solely for preoperative preparation of the patient.
2. G315, G319, G174, G111 and G112 are uninsured services for routine annual stress tests in asymptomatic patients where the patient's 10 year risk of coronary heart disease is less than 10% calculated by generally accepted methodology.
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