G536 – Sclerotherapy including one post injection visit, unilateral
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Sclerotherapy is an insured service for veins greater than 5 mm in diameter that are associated with physical symptomatology. This service must be rendered personally by the physician. The fee for G536 is for a unilateral procedure and includes: - Multiple injections during the session. - Application of any necessary compression bandages. - One post-injection follow-up visit. Note that professional and/or technical fees for obtaining and/or interpreting images for the purpose of guidance are not eligible for payment in addition to this service. G537 is used for repeat sclerotherapy.
When to Use
- Use G536 for the initial sclerotherapy session on a unilateral limb for symptomatic varicosities exceeding 5 mm in diameter.
- Use G536 when the procedure involves multiple injections and the application of compression bandages in a single session.
Common Pitfalls
- Billing G536 for cosmetic vein treatment, which is not an insured service under OHIP.
- Attempting to bill an additional office visit code (e.g., A007) for the post-injection follow-up, which is explicitly included in the G536 fee.
- Submitting claims for ultrasound guidance fees in addition to G536, which will result in automatic rejection.
Billing Tips
- Reserve G537 for subsequent repeat sessions on the same limb and ensure the clinical documentation clearly justifies the medical necessity of the ongoing treatment.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.