G321 – Programmable including electrocardiography, interrogation and reprogramming - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Professional component for the interrogation, analysis, and reprogramming of a programmable automatic implantable defibrillator. This service includes all aspects of electrocardiography, device interrogation, and any necessary reprogramming.
When to Use
- Use G321 when performing a comprehensive interrogation and reprogramming of an automatic implantable cardioverter-defibrillator (AICD) that requires professional interpretation of the device's stored electrograms.
- Select G321 instead of G317 when the clinical encounter necessitates active adjustment of device parameters (reprogramming) rather than simple diagnostic interrogation alone.
Common Pitfalls
- Billing G321 alongside a standard office visit (A007) is often flagged by OHIP; ensure the service meets the criteria for a separate diagnostic procedure if claiming both.
- Attempting to claim G321 with after-hours procedure premiums (E409 or E410) will result in automatic rejection as G321 is not classified as a Major Invasive Procedure.
Billing Tips
- Always append the appropriate Special Visit Premium if the interrogation is performed on an urgent or non-elective basis in a hospital or emergency setting to maximize the claim value.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate medical records to establish that the service was provided, medically necessary, and that the service for which the account is submitted is the service that was rendered.
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