G233 – Percutaneous celiac, splanchnic or hypogastric ganglion/plexus block with fluoroscopic guidance
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
A percutaneous block of the celiac, splanchnic, or hypogastric ganglion or plexus, performed as an interventional pain injection. This service requires the use of fluoroscopic guidance.
When to Use
- Use G233 for therapeutic celiac plexus blocks in patients with intractable abdominal pain secondary to pancreatic malignancy.
- Use G233 for diagnostic or therapeutic hypogastric plexus blocks in patients with chronic pelvic pain unresponsive to conventional analgesia.
- Use G233 when performing splanchnic nerve blocks to manage visceral pain, provided fluoroscopic guidance is utilized to confirm needle placement.
Common Pitfalls
- Billing G233 alongside separate fees for fluoroscopic guidance or nerve stimulation is prohibited, as these are considered inclusive of the procedure fee.
- Attempting to bill a separate local anaesthetic injection code (e.g., G372) in addition to G233 will result in rejection, as local infiltration is considered part of the procedure.
- Failure to document the use of fluoroscopy specifically in the procedure note will lead to audit recovery, as fluoroscopic guidance is a mandatory requirement for this code.
Billing Tips
- Always append E444 if performing radiofrequency ablation or E445 if using alcohol/sclerosing agents to increase the base fee by 50%.
- Ensure the procedure note explicitly details the anatomical target and the use of fluoroscopic imaging to satisfy the specific documentation requirements for G233.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
Fluoroscopic guidance must be used and documented for this service to be eligible for payment.
As per , all insured services must be documented in the patient's medical record to establish that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary.
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