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G550
G550 – Pessary care – pessary removal, care and reinsertion
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service is for the medical management of prolapse and involves pessary removal, care, and reinsertion. Per payment rule 4 on (), this service is not eligible for payment if the pessary removal is performed without care and reinsertion. The commentary on states that a visit fee may be claimed in addition to G550 for the same patient during the same visit.
When to Use
- Use G550 when you perform the full cycle of removing a pessary, cleaning or inspecting it, and reinserting it for a patient with pelvic organ prolapse.
- Bill G550 alongside a standard office visit fee (e.g., A007) when the encounter involves both the procedural care of the device and a clinical assessment of the patient's condition.
Common Pitfalls
- Do not bill G550 if you only remove the pessary without reinserting it, as the code explicitly requires the full cycle of care.
- Avoid billing G550 on the same day as G398, as these are mutually exclusive and will result in a rejection.
- Do not attempt to bill G550 as a stand-alone procedure if the primary purpose of the visit is a routine assessment; ensure the procedural work is clearly documented to justify the additional fee.
Billing Tips
- Always pair G550 with an appropriate visit fee code to maximize the value of the encounter, as the procedural fee alone is minimal.
Provider Fee$10.00
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
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