G257 – Intrapleural block (with the introduction of a catheter for the purpose of continuous analgesia)
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service covers the performance of an intrapleural block which includes the introduction of a catheter specifically for the purpose of continuous analgesia. Subsequent management of the catheter may be billable as a subsequent visit.
When to Use
- Use G257 when placing an intrapleural catheter specifically for continuous pain management in patients with rib fractures or post-thoracotomy pain.
- Select G257 instead of G258 when the procedure involves the active insertion of a catheter for ongoing analgesia rather than a single-injection nerve block.
Common Pitfalls
- Billing G257 in conjunction with G279 or G258 will result in an automatic rejection due to restricted code combinations.
- Attempting to claim after-hours procedure premiums (E409, E410, E412, E413) with G257 is a common error as this code is not classified as a Major Invasive Procedure.
Billing Tips
- Bill subsequent daily management of the catheter as a subsequent visit code, ensuring the documentation clearly reflects the assessment and adjustment of the continuous infusion.
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. The record must 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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