G190

PDF page 211 / A83

Initiation of Food Allergy Immunotherapy (FAIT)
       Initiation of Food Allergy Immunotherapy (FAIT) is an assessment service rendered by a
       specialist in Clinical Immunology where the physician spends a minimum of 30 minutes
       (consecutive or non-consecutive) in direct in-person contact with the patient, exclusive of time
       spent rendering any other separately billable intervention to the patient, for the purpose of
       establishing and initiating:
                • the FAIT treatment protocol (mono- or poly-allergen), and
                • initial therapy doses.
       The physician must be physically present on-site and immediately available to intervene for the
       duration of the treatment session, or the service is not eligible for payment.
   A620 Initiation of Food Allergy Immunotherapy ...............................        190.60
       Payment rules:
       1.No other services listed under the "Consultations and Visits" section of the Schedule are
          eligible for payment for the same patient on the same date of service as A620
          2.Provocation testing (G208 and G190) is not eligible for payment for the same patient on the
            same date of service as A620.
          3.Time used to establish the minimum time requirements for one patient cannot overlap with
            time used to establish time units or minimum time requirements for any other patient
          4.Limited to a maximum of once per patient per allergen per lifetime
          5.Limited to a maximum of once per treatment protocol whether initiating mono-allergen or
            poly-allergen therapy
          6.A620 is only eligible for payment in circumstances where a clinical history consistent with
            IgE-mediated food allergy has been supported by appropriate diagnostic evaluation,
            including skin prick testing, allergen-specific IgE testing, oral food challenge, or a
            combination thereof
          7.A written FAIT treatment protocol must be recorded in the patient’s permanent medical
            record, including the allergens involved, initial dosing schedule, and risk assessment
          8.In circumstances where the above payment rules have not been met, the service will be
            adjusted to a lesser paying fee
          Medical record requirements:
          The service is eligible for payment only if start and stop times of the service are recorded in the
          patient's permanent medical record.

PDF page 419 / J5

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
 ALLERGY
                                                                                                              Fee
      [Commentary:
      See General Preamble GP7 for definitions and time keeping requirements.]
   G190 Serial oral or parenteral provocation testing to a food, drug or
          other substance when the service is rendered in a hospital,
          when an anaphylactic reaction is considered likely based on
          a documented history and the service is performed under
          direct and ongoing physician attendance ...........................  184.95
          [Commentary:
          See G208 for similar services rendered in office.]
                                                                                                       T       P
     Skin testing
   G209 - technical component, to a maximum of 50 per year
            ............................................................................... per test   0.80
   G197 - professional component, to a maximum of 50 per year
            ............................................................................... per test           0.39
                                                                                                              Fee
        Venom allergy testing
         Investigations including skin prick test(s), intracutaneous test(s) and any other procedures
         necessary to establish the role of venom allergy in contributing to a patient's illness(es).
   G199 Venom allergy testing, maximum of 2 per patient per physician
          per 12 month period ..........................................................                      40.00
   G195 Local anaesthetic hypersensitivity skin test, maximum of 2 per
          patient per physician per 12 month period ........................                                  17.00
   G196 Hypersensitivity skin test for validated drugs or agents
          excluding foods and inhalants, maximum of 3 per patient per
          physician per 12 month period ..........................................                            17.00
   E582   - when testing with penicillin minor determinant mixture
            outside a hospital setting, to G196............................. add                              32.20
        Physical urticaria challenges - to include at least 3 of the following:
         a. assessment of dermographic challenge with 100, 250 or 500 gm needle, measuring
            immediate and delayed responses,
         b. assessment of pressure challenge with 15 lbs. weight recording onset, peak, duration of
            response - immediate and delayed,
         c. assessment of ice cube cold challenges,
         d. assessment of cholinergic exercise challenge with use of treadmill or bicycle to target pulse
            rate greater or equal to 120 per minute and profuse sweating,
         e. vibration effect of light and water,
         f. histamine or methacholine

Master, record 1904. Record Layout PDF, page 1.

G19020250401999999990000184950000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.