Dr. Alden
Billing and Diagnostic Code
Cheat Sheet
OHIP — Effective April 1, 2026
🆕 New Codes — April 2026 NEW
▼
CodeDescriptionFee
H114Weekday eve premium (Mon–Thu)$24
H264ED pelvic exam w/ speculum$12
A320MAID consultation$174.25
Key Changes April 2026 • Eve (H13X) now Mon–Thu only (not Friday)
• Wkd/Hol (H15X) now includes Fri eve 5pm–midnight
• H113 premium now includes Friday evening
• Anaesthesia unit: $15.49 → $15.96
• A007 increased 17.4% to $44.55
• Abscess / laceration / suture fees up 9–65%
• Z756 fecal disimpaction: $36.80 → $46.00
• Z104 perianal abs (LA): $20.10 → $33.25 (+65%)
• K-code fees increased ~14.1%
📋 ED Assessment Codes
▼
TimeMinorCompMultipleReassess
Day 8am–5pm H101 $23 H102 $57 H103 $47 H104 $23
Eve* 5pm–12am H131 $30 H132 $75 H133 $62 H134 $30
Night 12am–8am H121 $40 H122 $100 H123 $81 H124 $40
Wkd/Hol** 8am–12am H151 $34 H152 $86 H153 $70 H154 $34
* Eve = Mon–Thu 5pm–midnight only (not Fri)
** Wkd/Hol = Fri eve 5pm+ / Sat / Sun / Hol 8am–midnight
Reassess: >2 hrs, change mgmt, not d/c or referral. Q2h max 3/pt/d
🚨 Critical Care
▼
Document times. Cannot see other patients simultaneously.
No reassessments with CC — add additional CC unit instead.
SituationUnitCode
Imminent Life-Threatening (Arrest / Trauma)
1st 15 min1st MDG521
2nd 15 min1st MDG523
Next 15 min ea (max 6)1st MDG522
OvernightH112
Diag thoracentesisZ391 $32
Ther thoracentesisZ392 $59
Potential Life-Threatening (Other Resusc)
1st 15 min1st MDG395
Next 15 min ea (max 7)1st MDG391
Overnight PremiumH112
Diag paracentesisZ590 $31
Ther paracentesisZ591 $58
Trauma ISS > 15
Trauma ISS > 15E420
Allowed with G395 but NOT G521 (included in G521): Other CC Procedures (bill with G-codes)
⭐ Premiums (per patient visit)
▼
CodeDescriptionFee
H112Night premium (midnight–8am)$51
H113Wkd/Hol + Fri eve premium$32
H114Weekday eve (Mon–Thu) NEW$24

Procedure Premiums
CodeDescriptionAmount
E413Overnight+40%
E412Eve / Wkd / Hol+20%
All Z & F codes eligible. Only highlighted G & J codes eligible for premiums.
📞 On-Call Codes
▼
Bill instead of H codes until maxed. A007 ($45) or G-code.
TypeWkday DayWkday EveWkd/HolNight
Travel H960 $37 H962 $37 H963 $37 H964 $37
1st pt
Max 5 / 5 / 10 / Unlimited		 H980 $20 H984 $60 H968 $75 H986 $100
Addl pt
Max 5 / 5 / 10 / Unlimited		 H981 $20 H985 $60 H989 $75 H987 $100
🤝 Consultations
▼
Must write referring MD billing # or contact info.
CodeDescriptionFee
H055Consult to ED (FRCPC)$126
H065Consult to ED (CFPC)$96
Phone Consult (≥10 min — cannot lead to f/u)
K734Referring physician$31
K735Consultant physician$40
🔧 Routine Procedures
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CodeDescriptionFee
Nerve Blocks & Access
J149CU/S guided procedure$47
G269Central line$31
G268Arterial line$31
G224Nerve block (ring etc.)$16
G060Major nerve block$55
G061Minor nerve block$30
G260Maj plexus block (3-in-1)$80
G231Dental block$34
Aspiration & Drainage
G370Knee aspiration$20
G328Joint aspiration (not knee)$40
E446U/S guided asp (addl)+$30
Z341Chest tube$70
Z804Lumbar puncture$68
Z437Cardioversion (max 3/d)$92
G211Intubation—
Z611Catheter—
Other
Z080Wound/ulcer debridement$20
G313EKG (must be d/c'd)$4
H100Ultrasound$20
Z399Endoscopy$93
Z432Exam under anaesthesia$54
G356NG tube$34
Z520NG tube change$11
Z538Hernia reduction$25
Z543Proctoscopy$9
Z608Manual foley declot$59
Z756Rectal disimpaction$46
G435Tonometry—
A920Misoprostol (incl ax)$161
S756Rem POC from OS$112
🪡 Sutures & Lacerations
▼
Adhesive strips or skin glue: 50% of fee
Location0–5 cm5.1–10 cm10.1–15 cm>15 cm
Face Z154 $39 Z177 $78 Z190 $111 Z192 $170
Body Z176 $22 Z175 $39 Z179 $55 Z191 $85

Complex Lacerations (>20 min — document times)
CodeDescriptionFee
Z187Complex face$92
Z188Complex non-face$92
Z189Complex zone 1$92
R024Acute earlobe$101
R525Muscle & skin$89
R578Extensor tendon$164
R606Phalanx amputation$161
P036Vaginal laceration$54
🔪 Incision & Drainage
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CodeDescriptionFee
Z101One abscess (LA)$28
Z102One abscess (GA)$49
Z173Two abscesses (LA)$33
Z1743+ abscesses (LA)$45
Z104Perianal (LA)$33
Z105Perianal (GA)$72
Z106Pilonidal (LA)$49
Z107Pilonidal (GA)$118
Z226Elbow bursa$97
Z227IM abscess / hematoma$101
Z506Oral abscess$51
Z510PTA$91
Z714Bartholin's (LA)$17
Z715Bartholin's (GA)$51
Z140Breast abscess (LA)$33
Z740Breast abscess (GA)$75
Z545Hemorrhoid$25
E318Pinna hematoma$92
Z110Subungual hematoma$17
Z128Nail removal$33
Z130Nail removal + cautery$63
🔍 Foreign Bodies
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CodeDescriptionFee
Z114Skin (LA)$25
Z115Skin (GA)$89
R517Muscle$108
Z915Ear (LA)$11
Z866Ear (GA)$51
Z311Nose (LA)$11
Z312Nose (GA)$51
Z847Eye$33
Z756Rectum / disimpaction$46
Z541Rectum (GA)$58
Z432AVagina (GA)$54
E023CFB vagina (sedation)6 units
S547Urethra$171
👂 ENT Procedures
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CodeDescriptionFee
G420Ear syringe$11
G403Epley manoeuvre$21
Z315Anterior nasal pack$15
Z316Posterior nasal pack$36
Z314Nasal cautery$12
F136Nasal # reduction$102
Z321Direct laryngoscopy$61
Z322Direct laryngoscopy w/ FB rem$106
Z324Indirect laryngoscopy w/ FB$45
D062TMJ reduction$52
📝 Counselling & Forms
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Counselling: min 20 min, mental health dx + times documented.
CodeDescriptionFee
K005Mental health counselling$63
K028STD / Needlestick management$63
K015Counsel family re: death / catastrophe$63
K623Form 1 (psych assessment)$105
K070Homecare application$32
K035Medical conditions report—
A771Death certificate$34
A777Pronouncement + death cert$34
H105Interim admission orders$29
A320MAID consultation NEW$174.25
💉 Anaesthesia
▼
Procedure must have a DOT (•) to be eligible for units. 1 unit = $15.96 (updated April 2026)
1
Write procedure billing code
2
Write # of time units after the C 1 unit = $15.96
3
Additional line if patient qualifies:
PatientCodeUnits
< 1 year oldE009C 4
1–8 years oldE019C 2
70–79 years oldE007C 1
> 80 years oldE018C 3
ProneE011C 4
SittingE024C 4
ASA IIIE022C 2
ASA IVE017C 10
ASA VE016C 20
ASA EE020C 4
BMI > 40E010C 2
ISS > 15E420C + 50%
4
Third line if qualifying time:
TimeCodeUnits
Eve / Wkd / HolE400C ___ (sum steps 2+3)
OvernightE401C ___ (sum steps 2+3)
🦴 Splints & Casts
▼
Only bill if no F or D code applies.
CodeDescription
Z201Finger
Z202Hand
Z203Arm / forearm / wrist
Z204Cast removal
Z211Long leg
Z213Below-knee
🦾 Fractures — Upper Extremity
▼
FractureCodeWith Reduction
Phalanx finger (closed)F004F005 •
— each additionalN/AE558
Phalanx finger (open)F004F007 •
MetacarpalF008F009 •
Bennett'sF012F013 •
ScaphoidF018N/A
Other carpalF102F016 •
Colles / SmithF027F028
Colles / Smith (w/ sedation)N/AF046 •
Radius or ulnaF031F032 •
OlecranonF034F035 •
Epicondyle (no cast)F029F037 •
Humeral shaft (no cast)F042F043 •
Humeral neck (no cast)F053F054 •
🦵 Fractures — Lower Extremity
▼
FractureCodeWith Reduction
Pelvis (pelvic binder)No feeF134 •
FemurNo feeF095 •
Patella (no cast)F085N/A
Tibia +/− fibulaF078F079 •
FibulaF082F083 •
AnkleF074F075 •
Ankle with plafond burstF074F104 •
CalcaneusF070F071 •
Metatarsal (no cast)F061N/A
Metatarsal (with cast)F062F063 •
Tarsal boneF066F067 •
Phalanx toeF056F058 •
— each additionalE560E561
🔄 Dislocation Reductions
▼
JointCode
Phalanx fingerD001 •
Phalanx finger (open)D003 •
Metacarpal / phalangealD004 •
CarpalD007 •
Pulled elbowD012 •
A/C or S/C joint (no red)D014 •
Shoulder (no sedation)D015
Shoulder (with sedation)D016 •
ElbowD009 •
HipD042 •
Knee (no cast)D038 •
Patella (no sed, no cast)D040
Patella (w/ sed, no cast)D031 •
AnkleD035 •
Tarso-metatarsal (no cast)D026 •
MetatarsophalangealD030 •
Interphalangeal toeD027 •
TMJD062 •
— each additionalE576
Fracture / Dislocation Notes • Ortho follow-up = 75%
• Unsuccessful reduction (same MD final) = 85%
• Unsuccessful reduction (diff MD final) = 75%
• All Z & F codes eligible for procedure premiums
• Only highlighted G & J codes eligible for premiums
🚨 Resus
▼
Acute MI410
Arrhythmia / Arrest427
Burns949
Drug overdose977
Hypotension447
Meningitis36
Sepsis38
Shock785
Sudden death798
Trauma959
COVID80
DVT451
PE415
Endocrain ab Lab790
🧠 Psych
▼
Drug Addiction304
Adjustment reaction309
Alcoholism303
Anxiety / Depression300
BAD296
Behaviour problem312
Legal problem906
Other Psychosis298
Parent–child problem899
Personality disorder301
Schizophrenia295
Situational Crisis309
🔬 Neuro
▼
Concussion850
CVA436
Dementia290
Epilepsy / Seizure345
Migraine346
Tension headache307
TIA435
🤰 OB & Gyne
▼
Abortion – Threatened640
Ectopic pregnancy633
Pregnancy / delivery650
PID614
STD99
Rape / Sexual Assault958
Vaginal bleeding626
Vaginitis616
Medst Pain626
Hyperemesis643
⭐ Most Common
▼
Adverse Drug Reaction977
Alcoholism303
AP / Nausea / Vomiting787
CP / Syncope785
Diabetes250
Drug Abuse304
Dyspnea / Cough786
Foreign body930
Headache / Dizzy / Paresthesia780
Head Injury854
Constipation564
Asthma403
CHF428
COPD492
Anemia285
Endocrain259
Hematuria599
Hypertension401
Palpitation785
Hypoglycemia259
Ill Defined / FTT799
Jaundice787
Pain muscle / joint781
Pneumonia486
Pyelonephritis590
Rectal Bleeding569
Urinary Tract Infection595
Viral illness / Viremia79
🩹 Derm
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Abscess685
Bug bite989
Bite (i.e. dog)615
Cellulitis682
Hematoma959
Hives708
Paronychia686
Rash691
Anaphylaxis995
Zoster539
👁️ HEENT
▼
Pharyngitis460
Tonsillitis463
Conjunctivitis / subconj hem372
Foreign body eye930
Misc eye problem379
Foreign body ear939
Otalgia / wax / tinnitus388
Otitis externa380
Otitis media382
Epistaxis786
Thrush112
Dental Caries / Abscess521
👶 Common Pediatrics
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Fever796
Gastroenteritis9
Head injury854
Strep Throat34
URTI / Pharyngitis460
Well Baby916
🔵 GU
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Epididymitis / orchitis604
Hematuria599
Renal colic788
Testicular torsion608
Urinary retention788
Needlestick905
🦴 MSK
▼
DescriptionCode
Dislocations
Elbow832
Finger834
Shoulder831
Other dislocation839
Fractures
Phalanges816
Metacarpals815
Carpals814
Radius / Ulna813
Humerus812
Clavicle810
Vertebrae (spinal injury)806
Vertebrae (no spinal injury)805
Skull803
Facial bones802
Ribs807
Pelvis808
Femur821
Tibia / Fibula823
Ankle824
Fracture & Dislocation829
Sprains / Strains
Lumbar724
Neck847
Wrist / Hand / Fingers842
Upper arm840
Knee / Leg844
Ankle / Foot845
Lacerations
Upper limb884
Lower limb894
Other laceration879