G068

PDF page 118 / GP104

GENERAL PREAMBLE
OTHER PREMIUMS
    Non-elective Surgical Procedures (including fractures or dislocations), Obstetrical Deliveries,
    Clinical Procedures Associated with Diagnostic Radiological Examinations, Ground Ambulance
    Transfer (K101), Air Ambulance Transfer (K111), Transport of Donor Organs (K102), Return
    Trip (K112), or one of the following Major Invasive Procedures:
    G060, G061, G062, G065, G066, G067, G068, G082, G083, G085, G090, G099, G117, G118,
    G119, G125, G176, G177, G178, G179, G211, G224, G246, G248, G249, G260, G261, G262,
    G263, G268, G269, G275, G277, G279, G280, G282, G287, G288, G290, G297, G298, G303,
    G309, G322, G323, G324, G330, G331, G336, G347, G348, G349, G356, G376, G379, G380,
    G509, J001 to J068, and X112 when required for intussusception

PDF page 486 / J72

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
NERVE BLOCKS FOR ACUTE PAIN MANAGEMENT
                                                                                                               Fee
  G061 Peripheral nerve block, minor .................................................                          30.00
     Payment rules:
     1. The G061 service must consist of one of the following:
            a.a block of one of: ilioinguinal and/or iliohypogastric, genitofemoral, lateral femoral
              cutaneous, saphenous, occipital, supraorbital, infraorbital or glossopharyngeal nerve;
            b.an intercostal block;
            c.a superficial cervical plexus block;
            d.a transversus abdominis plane (TAP) block; or
            e.a paravertebral block – additional injection.
         2. G061 is limited to a maximum of 4 services per patient per physician per day.
         3. When a minor peripheral nerve block is rendered, additional blocks of one or more nerves
           within the same nerve distribution are not eligible for payment.
    Percutaneous nerve block catheter insertion for continuous infusion analgesia
# G279 Percutaneous nerve block catheter insertion..........................          80.00
     Payment rules:
     1. G279 is eligible for payment in addition to the applicable peripheral nerve or plexus block.
         2. G260 is not eligible for payment in addition to G279 when rendered for a continuous
           combined 3-in-1 block; G060 is eligible for payment in addition to G279 in this circumstance.
         3. No guidance (e.g. nerve stimulation, ultrasound) used for percutaneous nerve block catheter
           insertion is eligible for payment.
  G066 Intrapleural block ....................................................................                  55.00
  G067 Intrapleural block with continuous catheter.............................                                 80.00
# G068 Epidural blood patch ...............................................................                   125.00
# G065 Epidural blood patch injected through existing epidural
         catheter ..............................................................................                62.50
  G224 Nerve block by same physician performing the procedure.....                   15.55
     [Commentary:
     Refer to the Preamble of this section for additional information regarding G224.]
  G247 Hospital visits, to a maximum of 3 per patient per day ...........            30.10
     Payment rules:
     G247 is only eligible for payment to the physician most responsible, or to a physician
     substituting for the physician most responsible, for providing management and supervision of
     a:
         1. continuous catheter infusion for analgesia for a hospital in-patient; or
         2. lumbar sub-arachnoid drainage catheter placed in association with a surgical procedure
           where there is increased risk of spinal cord ischemia.
         [Commentary:
         G247 is not for visits to patients solely receiving intravenous pain management, such as patient
         controlled analgesia alone; a continuous nerve/plexus block or epidural/spinal catheter must be
         present for G247 to be payable.]

PDF page 490 / J76

Epidural and spinal injections
      Percutaneous epidural injections
# G246 Lumbar....................................................................................                150.00
# G117 Thoracic ..................................................................................               170.00
# G119 Cervical...................................................................................               190.00
# G918 Caudal ....................................................................................                74.20
  E440    - with injection of contrast using fluoroscopy, to G246, G117,
            G119 or G918 ............................................................ add                         30.00
  E441    - when performed at same level of previous spinal surgery,
            to G246, G117, G119 or G918 ................................... add                                   16.60
  E442    - when performed using a transforaminal technique, to
            G246, G117, G119 or G918 ....................................... add                                  20.00
  E443    - with catheter for continuous infusion, to G246, G117, G119
            or G918 ...................................................................... add                    80.00
# E833    - with insertion of subcutaneous port, G117, G119, G246 or
            G918 .......................................................................... add                  116.10
         Payment rules:
         1. Percutaneous epidural injections are limited to 12 services per patient per 12 month period
           for any combination of G119, G117, G246 and G918. 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. G246, G117, G119 or G918 are only eligible for payment same patient same day with G236,
           G234 and G920 if rendered to diagnose or treat a separate condition.
         [Commentary:
         The sympathetic block that may result from an epidural injection is not payable as G920, G234
         or G236.]
         3. G246, G117, G119 or G918 are not eligible for payment with any concurrent surgical
           procedure or any anaesthetic fee, except for E030C or E031C when indicated as described
           in the General Preamble Anaesthesiologist Services.
         [Commentary:
         1.For initiation and management services for outpatient palliative epidural infusion, refer to
           G063 and G064 page J73.
         2.For epidural blood patch, refer to G068 and G065 page J72.]
  G245 Lumbar epidural or intrathecal injection of sclerosing solution                                           180.00
  G239 Differential intrathecal spinal block .........................................                           127.60
# G919 Percutaneous epidural adhesiolysis by infusion with
          fluoroscopic guidance.........................................................                         400.00
         Note:
         G919 is only eligible for payment if the following conditions are met:
         1.it is used for the treatment of epidural fibrosis with symptoms of persistent back or radicular/
           neuropathic leg pain following spinal surgery;

Master, record 1845. Record Layout PDF, page 1.

G06820250401999999990000125000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.