G420 – Ear syringing and/or extensive curetting or debridement
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
A diagnostic and therapeutic procedure for ear syringing and/or extensive curetting or debridement, which may be performed unilaterally or bilaterally. Per the note on , G420 is only insured when: - There is impacted ear wax resulting in hearing loss that is unresponsive to topical application of cerumenolytics; or - Immediate removal of ear wax is medically necessary to visualize the tympanic membrane or the external ear canal for diagnostic and/or therapeutic purposes.
When to Use
- Use G420 when a patient presents with symptomatic cerumen impaction causing documented hearing loss that failed a trial of over-the-counter cerumenolytics.
- Use G420 when cerumen must be removed immediately to perform an otoscopic examination to rule out acute pathology like otitis media or a foreign body.
Common Pitfalls
- Billing G420 alongside a general assessment code like A007 or A001 is permissible, but it is strictly prohibited if billed with Z906, Z907, Z908, or Z913.
- Submitting G420 on the same day as a counselling code (e.g., K013 or K040) will result in a rejection per GP58 rules.
- Claiming G420 for routine ear cleaning without documented hearing loss or a specific diagnostic requirement for visualization will lead to audit recovery.
Billing Tips
- Ensure your chart note explicitly states the 'medical necessity' for the procedure, such as 'unable to visualize TM due to impacted cerumen' or 'failed trial of drops', to satisfy the requirements of J98.
- Since G420 is a procedure code, it can be claimed in addition to an office visit fee (A007) provided the documentation supports both the assessment and the procedural intervention.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures, Delegated Procedure
1. G420 is not eligible for payment when rendered in addition to Z906, Z907, Z908 or Z913.
2. G420 is only insured when: a. there is impacted ear wax resulting in hearing loss that is unresponsive to topical application of cerumenolytics; or b. immediate removal of ear wax is medically necessary to visualize the tympanic membrane or the external ear canal for diagnostic and/or therapeutic purposes.
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