G651 – Technical component - 12 to 35 hours recording
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This is the technical component (recording) for a Level 1 Continuous ECG Monitoring service (e.g., Holter) for a duration of 12 to 35 hours. A Level 1 service requires a device meeting specific criteria as outlined on page of the Schedule: * Device Capability: Must be capable of recording three or more simultaneous channels and acquiring a continuous ambulatory electrocardiographic recording of all beats using three or more skin electrodes. * Analysis and Review: The device must have the ability to analyze and manually review all parts of the recording, and to produce graphical and quantitative reports of relevant parameters and diagnostic quality tracings for visual review, including post-hoc review of any portion of the recording to enable diagnostic rhythm analysis. * Patient Diary: Must include a patient diary and event marker capability to enable symptom-rhythm correlation. * Duration: A minimum of 12 hours of monitoring is required for this service category.
When to Use
- Use G651 when you provide the technical recording component for a 12 to 35-hour Holter monitor that meets the three-channel, manual review, and diary requirements.
- Use this code specifically for the recording phase; it is distinct from the professional interpretation component (G654) and the scanning/analysis component (G657).
Common Pitfalls
- Billing G651 alongside G650 or G652 will result in an automatic rejection as these codes are mutually exclusive based on recording duration.
- Failing to account for the 13.9% reduction in the technical fee when the service is rendered in a hospital setting (payable at 86.10% of the listed fee).
- Submitting for the technical component without maintaining the required patient diary and event marker documentation, which is a mandatory audit requirement.
Billing Tips
- Ensure your billing software is configured to apply the hospital payment adjustment automatically when the service location is set to a hospital facility to avoid manual reconciliation errors.
- Always pair G651 with the appropriate professional component (G654) and scanning component (G657) to ensure the full Holter service is captured across the three distinct billing segments.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate the above upon request by the MOH.
Maximum one professional component, one technical recording component and one technical scanning component per patient, per recording.
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