L847 – Caffeine - halothane contracture test and other confirmatory tests for malignant hyperthermia
OHIP Dermatology Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
The caffeine - halothane contracture test and other confirmatory tests for malignant hyperthermia is a specialized laboratory procedure. As an insured service, it includes all common elements as defined in the Schedule of Benefits (-), such as record keeping, and arranging appointments and follow-up care.
When to Use
- Use L847 when performing the gold-standard caffeine-halothane contracture test on muscle biopsy specimens to confirm a diagnosis of malignant hyperthermia susceptibility.
- Apply this code for specialized confirmatory laboratory diagnostic procedures specifically indicated for patients with a clinical history suggestive of malignant hyperthermia.
Common Pitfalls
- Billing L847 for routine diagnostic laboratory tests or general muscle biopsy pathology (such as those covered under L834 or L835) will result in rejection as it is restricted to specific malignant hyperthermia protocols.
- Submitting L847 without the associated pathology report confirming the specific contracture testing methodology is a primary trigger for post-payment audit.
Billing Tips
- Ensure the claim is submitted by the laboratory facility or the pathologist performing the specific contracture test, as this code is not intended for the referring physician's office visit.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Laboratory
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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