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G500 – Insulin initiation or initial specialist assessment

OHIP Diagnostic and Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

This service is for the month in which insulin injections (2 or more daily) or insulin by pump is initiated; or the month in which the initial assessment by a specialist of a diabetic patient treated with insulin injections (2 or more daily) or insulin by pump occurs, requiring one or more contacts. A 'contact' is defined as the provision to a patient, patient's relative(s), patient's representative or other caregiver(s) of medical advice, direction or information by telephone or otherwise, in which a change in the frequency or dose of insulin therapy is initiated regarding a patient. In addition to the common elements (, ), the components of this service include the following specific elements: A. Monitoring the condition of a patient with respect to insulin therapy, including ordering blood tests, reviewing patient's glucose self-monitoring, interpreting the results and inquiry into possible complications. B. Adjusting the type, frequency and dose of insulin therapy, and where appropriate, prescribing alternate or additional therapy. C. Discussion with, and providing advice and information to the patient, patient's relative(s), patient's representative or other caregiver(s), by telephone or otherwise, on matters related to the service, regardless of identity of person initiating discussion. D. Making arrangements for any related assessments, procedures and/or therapy and interpreting results as appropriate. E. Providing premises, equipment, supplies and personnel for the specific elements.
As with all insured services, an appropriate medical record must be kept to establish that the service was medically necessary and rendered. ()
The 'contact(s)' leading to a change in insulin therapy should be documented in the patient's medical record.

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