G246 – Lumbar epidural injection
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G246 represents a percutaneous epidural injection performed in the lumbar region. This service is categorized as a diagnostic and therapeutic procedure for interventional pain management. The sympathetic block that may result from this epidural injection is considered an integral part of the service and is not separately payable as G920, G234, or G236. For related procedures, physicians should refer to G063 and G064 for outpatient palliative epidural infusion (page ), and G068 and G065 for epidural blood patch (page ).
When to Use
- Use G246 for percutaneous lumbar epidural injections performed for diagnostic or therapeutic pain management.
- Use G246 when the procedure is distinct from palliative epidural infusions (G063, G064) or epidural blood patches (G068, G065).
Common Pitfalls
- Attempting to bill G920, G234, or G236 for a sympathetic block resulting from the G246 injection will result in rejection, as these are considered integral to the procedure.
- Submitting G246 with concurrent surgical or anesthetic fees (excluding E030C or E031C) will trigger a billing error.
Billing Tips
- Always append appropriate add-on codes like E440 (fluoroscopy), E442 (transforaminal technique), or E441 (same level as previous surgery) to maximize the claim value when applicable.
- If you must bill G246 on the same day as G920, G234, or G236, ensure the clinical record explicitly justifies that the services were for separate, distinct conditions to avoid automatic rejection.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
If more frequent treatments than the specified limit are necessary, the physician must obtain written prior authorization from the MOH. Authorization is dependent on the physician demonstrating that the increased frequency of the service is generally accepted as necessary for the patient under the circumstances.
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