G407 – Ventilatory support - 31st day onwards
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 G407 for daily management of a patient requiring mechanical ventilation starting on the 31st day of continuous ventilatory support.
- Apply this code specifically for patients who have already exhausted the billing periods for G405 (days 1-7) and G406 (days 8-30).
Common Pitfalls
- Billing G407 before the 31st day of continuous ventilation will result in automatic rejection; ensure the start date is accurately tracked from the initial intubation.
- Attempting to bill separate procedure codes for arterial lines or blood gas interpretations is a violation of the Schedule of Benefits, as these are considered inclusive in G407.
- Failure to account for the 'transfer rule'—where a transfer from comprehensive care counts as the second day—often leads to incorrect billing of G406 versus G407.
Billing Tips
- Maintain a clear log of the ventilation start date to ensure the transition from G406 to G407 occurs exactly on the 31st day to avoid audit discrepancies.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.