G225 – Mental branch of mandibular nerve
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
A percutaneous injection for a nerve block of the mental branch of the mandibular nerve. This service is considered a therapeutic procedure and is not payable if performed solely as a method of local anaesthesia for another procedure performed by the same physician (see ). The service includes all common elements of an insured service as outlined in - of the Schedule of Benefits.
When to Use
- Use G225 for therapeutic management of chronic neuropathic pain or trigeminal neuralgia localized to the distribution of the mental nerve.
- Use G225 for diagnostic nerve blocks to confirm the mental nerve as the source of a patient's localized facial pain syndrome.
Common Pitfalls
- Billing G225 when the injection is used solely for local anesthesia to facilitate a separate procedure, such as a biopsy or laceration repair, which is explicitly prohibited.
- Attempting to bill G225 alongside an office visit code (A007) for the same encounter, which will trigger a rejection as the procedure includes the assessment.
Billing Tips
- If the procedure is performed in an emergency department or hospital setting, ensure you append the appropriate Special Visit Premium (Table I-III) to capture the visit component, as G225 only covers the procedural fee.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
As per , all insured services must be documented in the medical record to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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