G920 – Percutaneous cervical sympathetic nerve block or Stellate ganglion block
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Percutaneous cervical sympathetic nerve block or Stellate ganglion block with ultrasound or fluoroscopic guidance, unilateral.
When to Use
- Use G920 for diagnostic or therapeutic stellate ganglion blocks performed under ultrasound or fluoroscopic guidance for conditions such as complex regional pain syndrome (CRPS) of the upper extremity.
- Use G920 when performing a cervical sympathetic block to manage intractable angina or post-herpetic neuralgia, provided the guidance requirement is met.
Common Pitfalls
- Do not bill G920 if the sympathetic block is an incidental result of an epidural, spinal, or peripheral nerve block, as this is explicitly excluded by the Schedule of Benefits.
- Avoid billing G920 and G234 on the same day for the same patient, as they are mutually exclusive and will result in a claim rejection.
- Failure to track the 24-service annual limit per patient; exceeding this without prior MOH authorization will lead to automatic payment denials.
Billing Tips
- If you utilize alcohol or other sclerosing solutions for the block, ensure you append the E445 add-on code to receive the 50% fee increase.
- If anesthesia services are provided during the procedure, bill them separately using E030C or E031C, as these are not bundled into the G920 fee.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures
1. G920 and G234 are each limited to a maximum of one unilateral or one bilateral procedure per patient per day to a limit of 24 services for any combination of unilateral and bilateral procedures per patient per 12 month period. If, in the opinion of the treating physician, more frequent treatments are necessary, the physician may obtain written prior authorization from the MOH. Authorization will be dependent on the physician demonstrating that the increased frequency of the service is generally accepted as necessary for the patient under the circumstances.
2. G920, G234 and G236 are only eligible for payment same patient same day with other nerve block and/or injection services if rendered to diagnose or treat a separate condition.
3. G234 is not eligible for payment with G920 same patient same day.
4. The sympathetic block that may result from epidural, spinal, plexus and peripheral nerve blocks is not payable as G920, G234 or G236.
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