G415 – Routine EEG - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This is the professional component for a routine electroencephalogram (EEG), which covers the interpretation and report of the procedure. As per the Schedule of Benefits, a routine EEG consists of at least a twenty-minute recording with referential and bipolar montages and at least eight channels (except in neonates). Hyperventilation and photic stimulation should be done in all cases where clinically possible.
When to Use
- Use G415 for the professional interpretation of a standard 20-minute routine EEG that includes both referential and bipolar montages.
- Use this code when the EEG includes mandatory activation procedures like hyperventilation and photic stimulation, provided they are clinically appropriate for the patient.
Common Pitfalls
- Billing G415 on the same day as G418, G543, or G496 will trigger a rejection, as only one of these professional components is payable per patient per day.
- Attempting to bill G415 alongside any overnight or daytime sleep study codes (e.g., J898, J899, J990) will result in a payment denial.
- Submitting G415 for a sleep-deprived or video-EEG that fails to meet the specific technical requirements for those higher-tier codes will result in an automatic reduction to the G415 fee level.
Billing Tips
- Ensure your report explicitly notes the inclusion of hyperventilation and photic stimulation to justify the routine EEG fee and avoid potential audit queries regarding procedure completeness.
- If performing a specialized EEG that does not meet the criteria for G541 or G543, bill G415 as the default professional component to ensure you receive the standard routine fee rather than a total rejection.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The interpretation report must be documented in the patient's medical record.
The amount payable for a sleep-deprived/induced EEG, or an EEG with time-locked video recording that does not meet the above requirements will be reduced to that for a routine EEG fees (i.e. G414 and G415/G418).
G414 is not eligible for payment with G541.
Only one of G415, G418, G543 or G496 are eligible for payment per day.
EEG services (i.e. G414, G415, G418, G496, G541, G543, G540, G545, G542, G546, G554, G555, or G544) are not eligible for payment with any overnight or daytime sleep study (i.e. J898, J899, J990, J896, J897, J895, J890, J889, J893 or J894).
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