G497 – Insulin hypoglycemia pituitary function test
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
The G497 is an insulin hypoglycemia pituitary function test performed to assess pituitary function. The fee for this service includes the performance of the test with or without the administration of Thyrotropin-releasing hormone (TRH) and/or Luteinizing-hormone-releasing hormone (LHRH), either alone or in combination. As per the Schedule, this service includes all common elements of insured services as described on pages -, such as history taking, maintaining medical records, and arranging follow-up.
When to Use
- Use G497 when performing an insulin tolerance test to evaluate the hypothalamic-pituitary-adrenal axis or growth hormone reserve.
- Use this code when the test protocol includes the administration of TRH or LHRH alongside insulin-induced hypoglycemia to assess multiple pituitary axes in a single session.
Common Pitfalls
- Billing G497 in addition to G493 or G494 for the same patient encounter is a common error, as G497 is intended to be comprehensive for the pituitary function test session.
- Submitting G497 without a valid referral from a physician or nurse practitioner will result in an automatic rejection, as this is a diagnostic procedure requiring a formal request.
Billing Tips
- Since G497 includes the administration of TRH or LHRH, do not attempt to bill these as separate diagnostic procedures; ensure the documentation reflects the full scope of the test performed.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
As per , all insured services must be documented in appropriate medical records. The record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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