OHIP billing for Immunizations

Content provided by guest blogger
 Linda Rehmund

A common claim submission error seen usually by general practitioners in an office setting would apply to immunizations. Physicians often leave out G700 ($5.10), the basic fee-per-visit premium, billed when the procedure performed is the sole reason for the visit. This add-on code is eligible for payment in addition to any of the following immunization codes G538, G590, G840, G841, G842, G843, G844, G845, G846, G847 or G848.  These can be found on page J43 under the section Immunizations in the 2014 SOB. All codes in this section marked with a '+' can be billed with G700. 

To avoid rejection the G700 and the immunization codes given above should be submitted on the same day, in the same claim, and only once per patient per day.  Again, remember that G700 applies only when the sole purpose of the claim is for providing immunization.  If there has been a consultation code entered then G700 would no longer apply, and you would only use the immunization code along with your consultation code. 

Additional information about G700 can be found on page J3 in the Preamble.