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G412

G4121st day following transplantation

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

This applies to the service of being in constant or periodic attendance following transplantation, to provide all aspects of care to the renal transplant patient. This consists of an initial consultation or assessment and such subsequent assessments as may be indicated, including ongoing monitoring of the patient's condition and intervening as appropriate. This fee is for the 1st day following transplantation and includes complete patient care.

When to Use

  • Use G412 specifically for the first 24-hour period of post-operative management following a renal transplant when you are the physician providing comprehensive care.
  • Apply this code when the patient requires constant or periodic attendance and multiple assessments throughout the first day, as it replaces the need for individual A007 or A005 assessment billings.

Common Pitfalls

  • Billing G412 in conjunction with any other assessment or consultation code on the same day will trigger an automatic rejection due to the 'complete patient care' inclusion rule.
  • Submitting G412 for non-renal transplant procedures is a common audit trigger; ensure the service is strictly limited to renal transplantation as per the Schedule of Benefits.
  • Attempting to bill G412 alongside G408 or G409 for the same patient on the same day is prohibited, as these codes are mutually exclusive.

Billing Tips

  • Ensure your documentation reflects the 'constant or periodic attendance' provided throughout the first day to justify the global nature of this management fee.
  • Verify that no other physician has billed a global management fee for the same patient on the same date to avoid duplicate payment denials.
Provider Fee$354.30

Effective: April 1, 2026

Since Apr 2004, this fee has increased 67.8% vs 58.5% CPI inflation
Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

ManagementFee

Code Classes

Diagnostic and Therapeutic Procedures

G412, G408, G409 includes complete patient care.

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