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G559

G559Critical care - 31st day onwards

OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

Per diem fee for the physician-in-charge for critical care services rendered to a patient from the 31st day of critical care onwards. This service is part of a sequence, following G557 (1st day) and G558 (2nd to 30th day), for the continuous management of a critically ill patient.

When to Use

  • Use G559 for the physician-in-charge when a patient remains in critical care beyond the 30-day limit covered by G558.
  • Apply this code for daily management of a patient who has exhausted the maximum 29 units of G558 in a single critical care episode.

Common Pitfalls

  • Billing G559 concurrently with C101 will result in an automatic rejection as these services are mutually exclusive.
  • Attempting to bill G559 before the 31st day of the critical care sequence will trigger a rejection, as the system strictly enforces the chronological progression from G557 to G558 to G559.

Billing Tips

  • Ensure your patient record clearly tracks the cumulative days of critical care to justify the transition from G558 to G559 upon the 31st day.
Provider Fee$122.80

Effective: April 1, 2026

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

ManagementFee

Code Classes

Diagnostic and Therapeutic Procedures

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