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G790
G790 – Acquired acute brain injury management - 1st day
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Per diem fee for the first day of management of a patient with an acquired acute brain injury. This service includes all necessary assessments and management for the patient on the first day of care for this condition in a hospital setting. It is intended for patients who are not stabilized. Subsequent days of care are billed using G791 and G792.
When to Use
- Use G790 for the initial 24-hour period of managing a patient admitted with a non-stabilized acquired brain injury, such as traumatic brain injury or acute stroke.
- Select G790 when you are the primary physician overseeing the acute management phase, provided you are not also billing critical care or ICU per diems for that patient.
Common Pitfalls
- Billing G790 alongside C101 or any ICU per diem codes will result in an automatic rejection, as these are mutually exclusive for the same patient on the same day.
- Submitting a consultation (A-code) or a subsequent hospital visit (C002) on the same day as G790 is a common billing error that triggers a rejection due to the inclusive nature of the per diem fee.
Billing Tips
- Ensure your documentation clearly reflects the non-stabilized status of the brain injury, as this is a mandatory clinical requirement for G790 eligibility.
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