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H264

H264Emergency department pelvic exam with speculum

OHIP Obstetrics Code · Schedule of Benefits

A pelvic examination performed using a speculum in an emergency department or hospital urgent care clinic setting.

When to Use

  • Use H264 when performing a speculum examination for suspected ectopic pregnancy, pelvic inflammatory disease, or vaginal bleeding in the emergency department.
  • Bill H264 alongside your primary assessment code (e.g., A405) when the clinical complexity of the emergency visit requires a formal speculum exam.

Common Pitfalls

  • Do not bill H264 for a bimanual exam alone, as the code specifically requires the use of a speculum.
  • Avoid billing H264 if the pelvic exam is performed as part of a sexual assault kit, as these are typically covered under specific provincial forensic billing arrangements rather than standard ED procedure codes.

Billing Tips

  • Always pair H264 with the appropriate ED assessment code (A405, A406, or A407) to ensure you are compensated for both the cognitive assessment and the procedural component.
Provider Fee$12.00

Effective: April 1, 2026

Service Type

Consultations and Visits

Code Classes

Procedure

The service is specifically for the use of a speculum during a pelvic exam in the emergency setting.

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