G387 – Intravenous local anaesthetic infusion for central neuropathic pain
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
An intravenous local anaesthetic infusion rendered for central neuropathic pain. Central neuropathic pain is defined as pain caused by a primary lesion or dysfunction that affects the central nervous system. This service is only insured for patients who have first undertaken but not responded to generally accepted medical therapy, such as treatment with both a tricyclic antidepressant and at least one anticonvulsant. The physician must remain in constant attendance during the infusion, and the procedure cannot be delegated.
When to Use
- Use G387 for patients with central neuropathic pain, such as post-stroke pain or multiple sclerosis-related pain, who have failed trials of both a tricyclic antidepressant and an anticonvulsant.
- Select G387 when performing a therapeutic intravenous local anaesthetic infusion, ensuring it is distinguished from diagnostic infusion procedures billed under Z811.
Common Pitfalls
- Billing G387 without explicit documentation of the specific tricyclic antidepressant and anticonvulsant trials will trigger an automatic rejection or audit recovery.
- Delegating the monitoring of the infusion to nursing staff or other personnel is a violation of the 'constant attendance' requirement and renders the service ineligible for payment.
- Confusing G387 with Z811; Z811 is for diagnostic testing, whereas G387 is strictly for the therapeutic management of central neuropathic pain.
Billing Tips
- Ensure your clinical notes explicitly state the names of the failed medications and the duration of the trials to satisfy the mandatory pre-requisite documentation requirements.
- Since G387 requires constant physician attendance, ensure your time-stamped notes reflect continuous presence throughout the entire duration of the infusion.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
The medical record for the service must document the prior medical therapy that the patient did not respond to or G387 is not eligible for payment.
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