G876 – Botulinum toxin injection - each additional injection
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service represents each additional botulinum toxin injection for the treatment of Oromandibular dystonia, limb dystonia, cervical dystonia, or spasticity. It must be billed with G875, which covers the first injection. A maximum of 11 units of G876 may be claimed per patient, per day, in addition to one unit of G875.
When to Use
- Use G876 for every injection site beyond the first one when treating spasticity or dystonia, up to a maximum of 11 units.
- Apply G876 when performing multiple intramuscular injections in a single session for cervical dystonia, provided G875 is billed for the initial site.
Common Pitfalls
- Billing G876 without G875 on the same claim will result in an automatic rejection.
- Exceeding the maximum of 11 units of G876 per day will trigger a hard edit and payment denial.
- Attempting to bill G876 for conditions outside the specified list of dystonias or spasticity is a common audit trigger.
Billing Tips
- Always append G878 when EMG guidance is utilized for two or more injections to maximize the claim value beyond the base G876 fees.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
This code applies to botulinum toxin injections for the following conditions: Oromandibular dystonia, limb dystonia, cervical dystonia or spasticity.
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