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G354

G354Anorectal manometry study

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

Anal-rectal manometry is a diagnostic procedure listed under the Gastroenterology sub-section of Diagnostic and Therapeutic Procedures. As per the and of the Schedule, the service includes all common elements of insured services such as history taking, maintaining medical records, and arranging follow-up care.

When to Use

  • Use G354 when performing a formal anorectal manometry study to evaluate fecal incontinence or chronic constipation, distinct from simple digital rectal exams.
  • Bill G354 for diagnostic assessment of anal sphincter tone and rectal sensation when these specific measurements are required for clinical management.

Common Pitfalls

  • Billing G354 in conjunction with an office assessment code (e.g., A007) during the same encounter will trigger a rejection, as the procedure fee is intended to be comprehensive.
  • Submitting G354 without a valid referral from a physician or nurse practitioner on file will result in a claim rejection per GP111 requirements.

Billing Tips

  • Ensure the clinical record explicitly details the manometry findings, as G354 is a technical procedure code that requires documentation of the diagnostic data obtained beyond a standard physical exam.
Provider Fee$61.80

Effective: April 1, 2026

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

Diagnostic

Code Classes

Diagnostic and Therapeutic Procedures

Referral RequiredFrom: Physician, NursePractitioner

All insured services must be documented in appropriate records to establish that the service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.

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