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G419
G419 – Tensilon test
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G419 represents the performance of a Tensilon test. This is a diagnostic procedure listed under the Neurology subsection of Diagnostic and Therapeutic Procedures.
When to Use
- Use G419 when performing a formal edrophonium (Tensilon) challenge to confirm a diagnosis of myasthenia gravis in a patient with ptosis or ophthalmoplegia.
- Use this code when the procedure is performed as a standalone diagnostic intervention, distinct from a routine neurological assessment.
Common Pitfalls
- Billing G419 in addition to a general assessment code (e.g., A005) during the same encounter is a common rejection, as the procedure is considered inclusive of the assessment unless specifically permitted.
- Failing to document the specific clinical response and the objective improvement in muscle strength, which is required to justify the medical necessity of the procedure.
Billing Tips
- If the Tensilon test is performed during an emergency or urgent visit, ensure you append the appropriate Special Visit Premium (Table I-X) to the encounter to capture the travel and service premiums, as G419 alone is a low-value procedure fee.
Provider Fee$20.60
Specialist Fee$0.00
Surgical Assistant Fee$0.00
Anaesthetist Fee$0.00
Non-Anaesthetist Fee$0.00
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
As per the general requirements in , the medical record must establish that the service was provided, that the service claimed is the service that was rendered, and that the service was medically necessary.
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