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G872
G872 – Botulinum toxin injection(s) for hemifacial spasm
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Botulinum toxin injection(s) for hemifacial spasm, (unilateral or bilateral). This service is a diagnostic and therapeutic procedure. As with all insured services, it includes the common elements as defined in the Schedule of Benefits (see - for details), such as obtaining patient history, maintaining medical records, and communication with other healthcare professionals.
When to Use
- Use G872 specifically for the treatment of hemifacial spasm; do not use it for blepharospasm, which requires G871.
- Apply this code when performing botulinum toxin injections for unilateral or bilateral hemifacial spasm as a therapeutic procedure.
Common Pitfalls
- Billing G872 in conjunction with an office visit (A007) is generally disallowed as the procedure code includes the assessment and injection process.
- Submitting G872 for cosmetic purposes or conditions outside the defined neurological indication will result in automatic rejection or audit recovery.
Billing Tips
- Ensure the diagnostic code on the claim aligns with hemifacial spasm (ICD-9 351.8) to prevent rejection for mismatching clinical indications.
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