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G221
G221 – Intercostal nerve - additional
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
When to Use
- Use G221 for the second, third, and subsequent intercostal nerve blocks performed during the same session as the initial block billed under G220.
- Apply G221 when treating multiple levels of intercostal neuralgia or post-thoracotomy pain where more than one nerve requires anesthetic injection.
Common Pitfalls
- Billing G221 without an accompanying G220 will result in an automatic rejection as it is strictly an add-on code.
- Attempting to bill G221 for multiple injections at the same nerve level is incorrect; it is intended for distinct, additional nerve levels only.
- Claiming G221 for bilateral procedures without clear documentation of the specific nerve levels treated can trigger audit flags for over-billing.
Billing Tips
- Ensure the number of units for G221 accurately reflects the total number of additional nerves blocked beyond the first one covered by G220.
- Explicitly document the specific intercostal levels treated (e.g., T5, T6, T7) to justify the quantity of G221 units submitted.
Provider Fee$16.95
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
As per the Health Insurance Act, the medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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