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G119 – Cervical epidural injection

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

Percutaneous epidural injection into the cervical spine. This service is listed as a major invasive procedure eligible for after-hours procedure premiums. Payment rules: 1. Percutaneous epidural injections are limited to 12 services per patient per 12 month period for any combination of G119, G117, G246 and G918. If, in the opinion of the treating physician, more frequent treatments are necessary, the physician may obtain written prior authorization from the MOH. Authorization will be dependent on the physician demonstrating that the increased frequency of the service is generally accepted as necessary for the patient under the circumstances. 2. G246, G117, G119 or G918 are only eligible for payment same patient same day with G236, G234 and G920 if rendered to diagnose or treat a separate condition. 3. G246, G117, G119 or G918 are not eligible for payment with any concurrent surgical procedure or any anesthetic fee, except for E030C or E031C when indicated as described in the General Preamble Anaesthesiologist Services. Commentary: • The sympathetic block that may result from an epidural injection is not payable as G920, G234 or G236. • For initiation and management services for outpatient palliative epidural infusion, refer to G063 and G064 page . • For epidural blood patch, refer to G068 and G065 page .
Pre-authorization required
Written prior authorization from the MOH is required if more than 12 services (in combination with G117, G246, G918) are performed per patient per 12-month period.

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