G696 – Professional component – 14 or more days recording
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Professional component for a Level 2 continuous ECG monitoring service, such as a Holter monitor, with a recording duration of 14 or more days. Level 2 monitoring applies to all other monitoring devices with fewer than three skin electrodes, or that record only portions of the monitoring period or do not provide trend analysis. A minimum of 12 hours of monitoring is required. The related technical components are G694 (recording) and G695 (scanning).
When to Use
- Use G696 when interpreting extended-wear patch monitors (e.g., Zio XT) that record for 14 days or longer, provided they utilize fewer than three skin electrodes.
- Select G696 instead of G653 when the monitoring duration exceeds 14 days, as G653 is restricted to shorter duration Holter monitoring.
Common Pitfalls
- Billing G696 alongside G650, G653, or G656 will trigger an automatic rejection due to mutual exclusivity rules for professional components.
- Submitting G696 without a corresponding G694 (technical recording) and G695 (technical scanning) claim for the same patient encounter often leads to audit flags regarding the completeness of the diagnostic service.
Billing Tips
- Ensure the clinical documentation explicitly confirms the recording duration met the 14-day threshold to justify the higher fee compared to shorter-term monitoring codes.
- Verify the device configuration meets the 'Level 2' criteria of fewer than three electrodes; if the device uses three or more electrodes, you must bill the appropriate Level 1 code instead.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
Maximum one professional component, one technical recording component and one technical scanning component per patient, per recording.
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