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G236 – Percutaneous lumbar, thoracic or sacral sympathetic nerve block with fluoroscopic guidance - unilateral or bilateral

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

A percutaneous injection to block the lumbar, thoracic, or sacral sympathetic nerves. This procedure is performed either unilaterally or bilaterally and requires the use of fluoroscopic guidance. Payment for this service includes all common elements of insured services such as obtaining history, maintaining medical records, and providing prescriptions if needed, as outlined in the Schedule of Benefits (-).
Pre-authorization required
Fluoroscopic guidance must be used and documented.
If billed on the same day as other nerve block or injection services, the medical record must document that this procedure was for a separate condition.
For services exceeding the frequency limit, documentation supporting the medical necessity for prior authorization from the MOH is required.

G236 is limited to a maximum of one per patient per day to a limit of 12 per patient per 12 month period. 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.

G236 is only eligible for payment same patient same day with other nerve block and/or injection services if rendered to diagnose or treat a separate condition.

The sympathetic block that may result from epidural, spinal, plexus and peripheral nerve blocks is not payable as G920, G234 or G236.

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