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G068

G068Epidural blood patch

OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

Epidural blood patch procedure. This service is listed under the 'Nerve Blocks for Acute Pain Management' section of Diagnostic and Therapeutic Procedures.

When to Use

  • Use G068 for the treatment of post-dural puncture headache (PDPH) following neuraxial anesthesia or diagnostic lumbar puncture.
  • Use G068 when performing an epidural blood patch to seal a dural tear, distinct from diagnostic nerve blocks coded under G065.

Common Pitfalls

  • Billing G068 in addition to a consultation or assessment code for the same patient encounter is often rejected unless the assessment is for a separate, unrelated clinical problem.
  • Failing to document the non-elective nature of the procedure can lead to the denial of after-hours premiums like E409 or E410.

Billing Tips

  • Ensure the procedure start time is clearly documented in the chart to support the application of after-hours premiums E409, E410, E412, or E413.
  • If the procedure is performed in an emergency setting, ensure the 'H' prefix is used for the claim to remain eligible for the specific Emergency Department physician premiums.
Provider Fee$125.00

Effective: April 1, 2025

Category

J. Diagnostic and Therapeutic Procedures

Subcategory

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

Service Type

Procedure

Code Classes

Diagnostic and Therapeutic Procedures

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