G555 – Ambulatory EEG monitoring - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service is the professional component for ambulatory EEG monitoring. It includes the interpretation of a 12 to 24 hour EEG recording. The associated technical component (G554) covers the set-up, including EEG electrodes, and recording of other physiological parameters deemed necessary to arrive at an appropriate electrographic diagnosis.
When to Use
- Use G555 when you have performed the formal professional interpretation of a 12 to 24-hour ambulatory EEG recording.
- Bill G555 only after the full recording period is complete and you have reviewed the data to provide a diagnostic report.
Common Pitfalls
- Billing G555 without the corresponding technical component G554, which is required to support the professional interpretation claim.
- Attempting to bill G555 for a standard routine EEG; this code is strictly reserved for ambulatory monitoring of 12 to 24 hours duration.
- Submitting G555 for an inpatient service if the patient was admitted to the hospital within 24 hours of the diagnostic procedure, as this violates the technical component payment rules.
Billing Tips
- Ensure your documentation clearly links the professional interpretation of G555 to the specific technical data captured under G554 to satisfy audit requirements for diagnostic services.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records. The Act requires that the record 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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