G620 – Neonatal intensive care - Level C - 1st day
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Neonatal Intensive Care is the service rendered by a physician for being in constant or periodic attendance during a one-day period, to provide all aspects of care to Intensive Care Area patients. This consists of an initial consultation or assessment and such subsequent assessments as may be indicated, including ongoing monitoring of the patient's condition and the following procedures as required: insertion of arterial, venous, C.V.P. or urinary catheters, intravenous lines, interpreting of blood gases, nasogastric intubation with or without anaesthesia, pressure infusion sets and pharmaceutical agents, endotracheal intubation, tracheal toilet, artificial ventilation and all necessary measures for respiratory support. Separately billable interventions may be claimed in addition to these fees. Level C: Intermediate care including one or more of oxygen administration, non-invasive monitoring or gavage feeding. G620 is for the 1st day of this care.
When to Use
- Use G620 for the first day of care for a newborn requiring intermediate intensive care, specifically involving oxygen administration, non-invasive monitoring, or gavage feeding.
- Use this code when the patient is under 28 days old and requires the comprehensive management fee that includes routine procedures like nasogastric intubation or intravenous line insertion.
Common Pitfalls
- Billing G620 in conjunction with G621 or other neonatal intensive care codes (G600-G611) for the same patient on the same day will result in an automatic rejection.
- Failing to apply the appropriate age premium (30% for <30 days or 25% for <1 year) results in significant underpayment, as these are considered specialist consultations.
- Billing G620 for a patient who has already been managed at a different level of care on the same day; if a transfer between levels occurs, you must transition to the second-day fee structure.
Billing Tips
- Ensure you append the correct age premium code to the G620 claim, as the system does not automatically calculate the 30% or 25% increase without the specific premium indicator.
- Since G620 is a comprehensive management fee, remember that you can still bill separately for procedures explicitly defined as 'separately billable' in the Schedule of Benefits that fall outside the scope of the intensive care bundle.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
ManagementFee
Diagnostic and Therapeutic Procedures
Newborn; or Infant up to 2 years
Physician-in-charge is the physician(s) daily providing the Neonatal Intensive Care.
These are team fees which apply to neonatologists /paediatricians/anaesthetists providing complete care. If infant has been transferred from one level to another in either direction, up or down, second day benefits apply.
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