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G385
G385 – Infiltration of tissues for trigger point - additional site
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service covers the infiltration of tissues for each additional trigger point after the first site has been treated and billed using G384. A maximum of two G385 services can be claimed per patient encounter, allowing for the billing of up to three trigger point sites in total (one G384 and two G385).
When to Use
- Use G385 for the second and third trigger point injection sites when you have already billed G384 for the initial site during the same encounter.
- Apply this code when treating multiple distinct myofascial trigger points in different muscle groups during a single visit, provided the total number of sites does not exceed three.
Common Pitfalls
- Billing G385 without an associated G384 on the same day will result in an automatic rejection.
- Claiming more than two units of G385 per patient encounter will trigger a rejection, as the maximum allowable total is three sites (one G384 and two G385).
- Attempting to bill G385 for multiple injections within the same muscle group or site is considered an audit risk, as the code is intended for distinct anatomical trigger points.
Billing Tips
- Ensure your clinical notes clearly document the anatomical location of each distinct trigger point to justify the use of G384 plus two units of G385.
Provider Fee$4.55
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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