G549 – Clinical Programming of Deep Brain Stimulator - additional implantation site
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Clinical Programming of Deep Brain Stimulator (DBS) for an additional implantation site. This service is performed for a patient who has more than one DBS implantation site. It is intended to be used in conjunction with G547 which covers the programming of the first implantation site. The service includes all necessary components for programming the additional site, such as checking, minor and major adjustments, and intensive programming. It is limited to a maximum of one service per patient.
When to Use
- Use G549 only when programming a second or subsequent DBS lead site during the same encounter as the primary programming service G547.
- Apply this code when the patient has bilateral DBS leads and both require independent parameter adjustments or interrogation during a single clinical session.
Common Pitfalls
- Billing G549 as a standalone service will result in rejection; it must be submitted on the same claim as G547 to satisfy the dependency requirement.
- Attempting to bill G549 more than once per patient per encounter is a violation of the code's limit and will trigger an automatic audit or rejection.
- Confusing G549 with G547; ensure G547 is billed for the first site and G549 is used strictly for the additional site(s).
Billing Tips
- Ensure your claim includes both G547 and G549 on the same date of service to avoid the 'missing primary code' error.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
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