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G345

G345Complex single agent or multi-agent therapy

OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

Complex single agent or multi-agent therapy – chemotherapy and/or biologic agent(s) that can cause vesicant damage, infusion reactions, cardiac, neurologic, marrow or renal toxicities that may require immediate intervention by the physician

When to Use

  • Use G345 when administering complex chemotherapy agents like taxanes or cisplatin that carry high risks of vesicant damage or renal toxicity.
  • Use G345 for the administration of monoclonal antibodies or cytokines, such as rituximab or trastuzumab, which require physician oversight for potential infusion reactions.

Common Pitfalls

  • Billing an office visit (A007) or consultation (A005) on the same day as G345 will trigger a rejection because the code includes all patient assessments for a 24-hour period.
  • Attempting to bill G345 for the administration of non-biologic agents like blood products or insulin is an audit risk, as these are explicitly excluded from the definition of biologic agents for this code.
  • Submitting G345 alongside G489 or G379 will result in a billing conflict as these codes are restricted from being claimed together.

Billing Tips

  • Ensure the claim includes the specific agent name in the notes field to justify the 'complex' classification and avoid manual review delays.
  • Remember that G345 is an all-inclusive fee; do not add separate claims for venipuncture or the establishment of vascular access lines as these are already bundled into the $75.00 payment.
Provider Fee$75.00

Effective: April 1, 2025

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

Procedure

Code Classes

Diagnostic and Therapeutic Procedures

G381, G345 and G359 are only eligible for payment with respect to the following classes of biologic agents: a. monoclonal antibodies; and b. cytokines.

G381, G345, G359, G075 and G390 include venipuncture, establishment of any vascular access line and administration of agent(s).

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