G473 – Complex neuromuscular electrodiagnostic testing - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Professional component, when physician performs EMG and/or performs or supervises nerve conduction studies and interprets the results. This is for complex neuromuscular electrodiagnostic testing requiring a minimum of 60 minutes of direct physician involvement. The testing must include ten (10) or more electrodiagnostic studies, performed through any combination of the following: Nerve conduction studies, Late motor response studies, Needle electromyography of distinct muscles, Repetitive stimulation of muscle-nerve pairs, Autonomic function studies. For the purposes of G471/G473, the cranial, cervical, thoracic and lumbosacral regions represent separate segments. Complex neuromuscular disorders where Schedule C nerve conduction studies/electromyography may be appropriate include demyelinating neuropathies, mononeuritis multiplex, motor neuron disease, brachial/lumbosacral plexopathies and neuromuscular transmission disorders.
When to Use
- Use G473 for extensive diagnostic workups in complex cases like ALS or multifocal motor neuropathy that require 60+ minutes of direct physician time and at least 10 distinct electrodiagnostic studies.
- Select G473 over G471 when the clinical complexity necessitates a more comprehensive assessment across multiple anatomical segments (cranial, cervical, thoracic, or lumbosacral) exceeding the standard diagnostic threshold.
Common Pitfalls
- Billing G473 without explicit start and stop times in the medical record is a primary cause for audit recovery, as the 60-minute minimum is a strict requirement.
- Attempting to bill G473 alongside G456 or G457 for the same patient on the same day will result in automatic rejection due to explicit billing restrictions.
- Failing to document the specific count of 10 or more electrodiagnostic studies (e.g., specific nerves tested or muscles sampled) often leads to claims being flagged for insufficient evidence of complexity.
Billing Tips
- If performing single fibre EMG (G458) in addition to G473, ensure your documentation clearly separates the time spent on G458 from the 60 minutes required for G473 to justify the additional fee.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
The start and stop time must be recorded in the patient's medical record.
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