G816 – Electrocochleography - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This fee code represents the professional component of electrocochleography, which involves the interpretation and reporting of the test findings by a physician. The technical component is billed separately using fee code G815. Electrocochleography is a diagnostic test that measures the electrical potentials generated in the inner ear and auditory nerve in response to sound stimuli. The professional component of a diagnostic procedure is only eligible for payment where the physician has the necessary training and experience to personally render the service.
When to Use
- Use G816 to bill for the formal interpretation and written report of electrocochleography results when you have personally supervised or reviewed the technical data generated by G815.
- Apply this code when diagnosing Meniere's disease or other inner ear pathologies where the summating potential to action potential ratio requires physician analysis.
Common Pitfalls
- Billing G816 without a corresponding G815 claim on the same date of service will trigger an automatic rejection as the technical component is a prerequisite for the professional interpretation.
- Submitting G816 for both ears on the same day without using the appropriate bilateral modifiers or separate line items for each ear will result in payment for only one side.
Billing Tips
- Ensure your clinical documentation explicitly states the interpretation of the electrical potentials, as the Ministry may audit G816 claims to verify that a professional report was generated beyond the technical tracing.
Effective: April 1, 2025
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 professional component of the service.
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