G911 – Thoracic facet injection, first site
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Percutaneous diagnostic injection with fluoroscopic guidance of a thoracic vertebral facet (first site). This procedure can be a facet medial branch block, facet joint injection, or sacral lateral branch block. This code is for the first site; see G913 for additional sites. See also G910 for cervical and G912 for lumbar/sacral first sites.
When to Use
- Use G911 for the first thoracic facet joint injection or medial branch block performed under fluoroscopic guidance.
- Use G911 when performing a diagnostic block on a single thoracic level to confirm the source of facet-mediated pain.
- Use G911 as the primary code when treating a single thoracic site, even if subsequent levels are treated using G913.
Common Pitfalls
- Billing G911 for cervical or lumbar procedures instead of the correct G910 or G912 codes will result in automatic rejection.
- Exceeding the limit of 6 services per 12-month period without prior Ministry authorization will trigger a claim rejection.
- Attempting to bill G911 for multiple thoracic levels in a single session without using G913 for the additional sites is a common billing error.
Billing Tips
- Always append G913 for each additional thoracic level treated after the first site billed under G911.
- Ensure fluoroscopic guidance is explicitly documented, as it is a mandatory requirement for the validity of the G911 fee.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
For services in excess of the frequency limit, written prior authorization from the MOH is required. Authorization depends on demonstrating that the increased frequency is generally accepted as necessary for the patient under the circumstances.
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