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G476
G476 – Prostatic massage
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Prostatic massage is a listed service under the urology subsection of diagnostic and therapeutic procedures.
When to Use
- Use G476 when performing a therapeutic prostatic massage for the management of chronic prostatitis or pelvic pain syndrome.
- Use this code when the procedure is performed as a standalone therapeutic intervention, distinct from a standard digital rectal exam (DRE) which is typically included in the assessment fee.
Common Pitfalls
- Billing G476 in addition to a general assessment code (e.g., A007) for the same patient encounter is often flagged as unbundling if the massage is considered part of the physical examination.
- Submitting G476 without a clear clinical indication of prostatic pathology in the chart notes will lead to recovery during a Ministry audit.
Billing Tips
- Ensure the procedure is clearly identified as a therapeutic massage rather than a diagnostic DRE to justify the additional fee separate from your visit code.
Provider Fee$5.40
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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