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G558
G558 – Critical care - 2nd to 30th day
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service is a per diem payment for the physician-in-charge responsible for the care of a patient in a critical care setting. It is applicable for each day from the 2nd day up to and including the 30th day of the critical care admission. This fee is part of a sequence with G557 (1st day) and G559 (31st day onwards).
When to Use
- Use G558 for the physician-in-charge managing a patient in an ICU setting on any day from day 2 through day 30 of their critical care admission.
- Apply this code when the patient remains in the critical care unit and you are providing ongoing management that supersedes standard subsequent visit codes.
Common Pitfalls
- Billing G558 alongside C101, C124, C142, or C143 will trigger an automatic rejection as these services are mutually exclusive.
- Attempting to claim a Special Visit Premium on the same day as G558 is a common audit trigger and will result in a payment reversal.
- Failing to transition to G559 after the 30th day of admission will lead to claim rejections for exceeding the maximum duration of G558.
Billing Tips
- Ensure your billing sequence correctly follows G557 for the first day, G558 for days 2-30, and G559 for day 31 onwards to avoid payment gaps.
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