G684 – Technical component - 60 hours to 13 days recording
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This fee code represents the technical recording component for a Level 1 continuous ECG monitoring service, commonly known as a Holter monitor, for a period ranging from 60 hours up to and including 13 days. Level 1 Requirements: The service must utilize a device capable of recording three or more simultaneous channels and acquiring a continuous electrocardiographic recording of all beats via three or more skin electrodes. The device must also facilitate analysis, manual review of the entire recording, and produce detailed reports with diagnostic quality tracings. Additionally, it must support a patient diary and an event marker for symptom-rhythm correlation. This fee covers the provision of the equipment and the recording process itself. The associated scanning component is billed as G685 and the professional component as G659.
When to Use
- Use G684 when a patient requires extended ambulatory ECG monitoring beyond 48 hours, specifically for a duration between 60 hours and 13 days.
- Use this code exclusively for Level 1 devices that provide three or more simultaneous channels of continuous recording, as opposed to single-channel event recorders.
Common Pitfalls
- Billing G684 for recordings shorter than 60 hours will result in rejection; ensure the device duration is set and verified to meet the minimum threshold.
- Attempting to bill G684 alongside G685 or G659 for the same patient encounter is standard, but failing to ensure the technical component (G684) is billed by the physician responsible for the quality assurance of the data acquisition will trigger audit flags.
- Billing G684 for devices that do not support manual review of the entire recording or lack patient diary integration violates the Level 1 technical requirement.
Billing Tips
- Ensure the technical component (G684), scanning component (G685), and professional interpretation (G659) are submitted as distinct line items to avoid processing errors.
- If the service is performed within a hospital setting, remember that the G684 fee is automatically adjusted to 86.10% of the listed value per the MOH payment rules.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The physician has the necessary training and experience to personally render the technical component of the service.
The physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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.
Level 1: Requires a device capable of recording three or more simultaneous channels and the acquisition of a continuous ambulatory electrocardiographic recording of all beats, using three or more skin electrodes. The device must also 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. Must include a patient diary and event marker capability to enable symptom-rhythm correlation. Minimum 12 hours of monitoring.
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