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G260
G260 – Major plexus block
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
A major plexus block is a block of one of the following: - brachial plexus - lumbar plexus - sacral plexus - deep cervical plexus, or - a combined 3-in-1 block which must include the femoral, obturator and lateral femoral cutaneous nerves.
When to Use
- Use G260 when performing a brachial, lumbar, sacral, or deep cervical plexus block for regional anesthesia or pain management.
- Use G260 for a combined 3-in-1 block, provided it explicitly includes the femoral, obturator, and lateral femoral cutaneous nerves.
- Use G260 when performing multiple individual peripheral nerve blocks that fall entirely within the distribution of a single major plexus.
Common Pitfalls
- Billing individual nerve blocks (e.g., radial, median, and ulnar) separately when they are part of a brachial plexus distribution; only G260 is payable.
- Attempting to bill G260 alongside additional minor nerve blocks that are already encompassed by the major plexus distribution, which will result in a rejection or recovery.
- Failing to distinguish between a major plexus block and a simple peripheral nerve block; G060 should be used for isolated peripheral nerves that do not constitute a major plexus.
Billing Tips
- If you perform a peripheral nerve block outside the distribution of the major plexus (e.g., a sciatic block alongside a 3-in-1 block), you may bill G260 and the additional block separately.
- Ensure the medical record explicitly lists the specific nerves blocked for a 3-in-1 procedure to justify the use of G260 over individual minor block codes.
Provider Fee$80.00
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
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