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G792
G792 – Acquired acute brain injury management - 31st day onwards
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This per diem fee is for the ongoing management of a patient with an acquired acute brain injury. It is applicable from the 31st day of care onwards. Payment is subject to several restrictions, including not being payable for stabilized patients or on the same day as Critical Care ICU per diem fees, consultations, assessments, or other time-based services. See payment rules on .
When to Use
- Use G792 for the ongoing daily management of an acquired acute brain injury patient who remains clinically unstable and requires active intervention beyond the 30-day threshold.
- Apply this code when the patient is transitioning through sub-acute recovery phases where active management of neurological complications is required, distinguishing it from the initial stabilization phase covered by G790 or G791.
Common Pitfalls
- Billing G792 for patients who have reached a stabilized state will trigger audit flags, as the code is strictly prohibited for stabilized patients regardless of the care setting.
- Submitting G792 on the same day as any consultation, assessment, or time-based service (such as K-codes for counseling) will result in automatic rejection due to the comprehensive nature of the per diem fee.
Billing Tips
- Ensure your documentation explicitly justifies the ongoing instability of the brain injury to satisfy the requirement that the patient is not yet stabilized, as this is the primary audit trigger for G792.
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