G916 – Percutaneous diagnostic and/or corticosteroid sacroiliac joint injection with fluoroscopic guidance, unilateral
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G916 is for a unilateral percutaneous diagnostic and/or corticosteroid sacroiliac joint injection with fluoroscopic guidance. This service involves injecting the sacroiliac joint on one side of the body for either diagnostic evaluation or therapeutic pain relief using corticosteroids. The use of fluoroscopy is a required component for visualizing the joint and guiding the needle placement accurately.
This procedure is listed in the Nerve Blocks - Interventional Pain Injections subcategory of the Diagnostic and Therapeutic Procedures section of the Schedule of Benefits. Like all insured services, it encompasses the common elements of care as detailed in the General Preamble (e.g., , ).
When to Use
- Use G916 when performing a unilateral sacroiliac joint injection specifically under fluoroscopic guidance for diagnostic or therapeutic corticosteroid delivery.
- Choose G916 over G917 when the procedure is strictly unilateral; G917 is the correct code for bilateral sacroiliac joint injections.
- Use G916 for patients requiring targeted joint space access where anatomical landmarks alone are insufficient, necessitating the mandatory fluoroscopic component.
Common Pitfalls
- Billing G916 alongside an office visit code (A007) is generally disallowed as the procedure fee includes the assessment and preparation required for the injection.
- Attempting to bill G916 for ultrasound-guided injections will result in rejection, as the code explicitly mandates fluoroscopic guidance.
- Submitting G916 for both sides during a single encounter is a common error; you must use G917 for bilateral procedures to avoid claim rejection or audit flags.
Billing Tips
- Ensure the operative note explicitly documents the use of fluoroscopy, as this is a mandatory requirement for the validity of the G916 claim.
- If procedural sedation is required by a second physician, bill E030C or E031C in conjunction with G916 to ensure the anaesthesia support is correctly captured.
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