G406 – Ventilatory support - 2nd to 30th day
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Ventilatory Support includes provision of ventilatory care including initial consultation and assessment of the patient, intravenous lines, endotracheal intubation with positive pressure ventilation including insertion of arterial C.V.P lines, tracheal toilet, use of artificial ventilator and all necessary measures for its supervision, obtaining and interpretation of blood gases, oximetry, transcutaneous blood gases and assessment. If the patient has been transferred from comprehensive care to ventilatory care, the day of the transfer shall be deemed for payment purposes to be the second day of ventilatory care.
When to Use
- Use G406 for daily management of a patient on a ventilator from the second day through the thirtieth day of continuous ventilatory support.
- Apply this code when the patient has been transferred from a comprehensive care unit to a ventilatory care unit, treating the transfer date as the second day of care.
Common Pitfalls
- Billing G406 concurrently with G400, G401, or G402 is prohibited as these codes are mutually exclusive for the same patient on the same day.
- Attempting to bill for individual procedures like arterial line insertion or blood gas interpretation separately is a rejection error, as these are inclusive to the G406 daily fee.
Billing Tips
- Ensure the patient's clinical record clearly tracks the duration of ventilation to justify the transition from G405 (initial day) to G406 (subsequent days).
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