G228 – Paravertebral nerve block of cervical, thoracic, lumbar, sacral or coccygeal nerves
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This procedure involves a paravertebral nerve block of the cervical, thoracic, lumbar, sacral, or coccygeal nerves. This fee is for the first nerve block performed. For each additional nerve block at a separate site, use the add-on code G123, which can be claimed up to a maximum of 4 times per encounter.
When to Use
- Use G228 as the primary code for the first paravertebral nerve block performed for therapeutic pain management in the cervical, thoracic, lumbar, sacral, or coccygeal regions.
- Select G228 when performing a standalone diagnostic or therapeutic nerve block that is not part of a larger surgical procedure performed by the same physician.
Common Pitfalls
- Billing G228 in conjunction with another surgical procedure performed by the same physician on the same patient will trigger a rejection, as the block is considered inclusive of the surgical fee.
- Attempting to claim more than four units of G123 in addition to G228 will result in automatic rejection, as the total allowed units for the add-on code is strictly capped.
- Failing to bill G228 as the base code before applying G123 will lead to claim errors, as G123 is specifically designed as an add-on to G228.
Billing Tips
- Always ensure G228 is listed as the primary procedure code to establish the base service before appending G123 for subsequent blocks at different sites.
- If performing a nerve block for post-operative pain control, ensure you are utilizing G224 instead of G228 to comply with the specific payment adjustment rules for surgical procedures.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records to 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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