G224

PDF page 115 / GP101

GENERAL PREAMBLE
 ANAESTHESIOLOGISTS’ SERVICES
  2. A major or minor peripheral nerve block, major plexus block, neuraxial injection (with or without
     catheter) or intrapleural block (with or without catheter) for post-operative pain control (with a
     duration of action more than 4 hours) is eligible for payment as G224 when rendered in
     conjunction with a procedure which the physician performs on the same patient. With the
     exception of a bilateral pudendal block (where only one service is eligible for payment), G224 is
     eligible for payment once per region per side where bilateral procedures are performed.
          [Commentary:
          For additional information, refer to the Nerve Blocks for Acute Pain Management, Interventional
          Pain Injections and the Peripheral/Other Nerve Block sections of the Schedule.]

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 484 / J70

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
NERVE BLOCKS FOR ACUTE PAIN MANAGEMENT
PREAMBLE
  1. Nerve blocks listed in this section are eligible for payment only when rendered for acute pain
     management, including peri-operative or post-operative pain management as described below
     and where the nerve block has a duration of action of more than 4 hours. Acute pain is defined
     as pain that occurs with sudden onset and that is expected to resolve within 6 weeks.
  2. Nerve blocks rendered for acute pain with a duration of action of less than 4 hours, topical
     anaesthesia or local infiltration used as an anaesthetic for any procedure, are not eligible for
     payment.
  3. Except as described in paragraph 4, when a physician administers an anaesthetic, nerve block
     and/or other medication prior to, during, immediately after or otherwise in conjunction with a
     diagnostic, therapeutic or surgical procedure which the physician performs on the same patient,
     the administration of the anaesthetic, nerve block and/or other medication is not eligible for
     payment.
  4. A major or minor peripheral nerve block, major plexus block, neuraxial injection (with or without
     catheter) or intrapleural block (with or without catheter) for post-operative pain control (with a
     duration of action more than 4 hours) is eligible for payment as G224 when rendered in
     conjunction with a procedure which the physician performs on the same patient.
  5. When a physician renders an anaesthesia service in support of a procedure performed by
     another physician, a peripheral nerve block, plexus block, neuraxial injection or intrapleural
     injection using short-acting medication (with a duration of action less than 4 hours) is not
     eligible for payment in addition to the C-suffix anaesthesia service.
  6. When a physician renders an anaesthesia service in support of a procedure performed by
     another physician, a peripheral nerve block, plexus block, neuraxial injection or intrapleural
     injection, listed in this section and performed for post-operative analgesia (with a duration of
     action more than 4 hours) is eligible for payment in addition to the C-suffix anaesthesia service.
      [Commentary:
      1.For the purposes of paragraph 6, only peripheral nerve blocks, plexus blocks, neuraxial
        injections or intrapleural injections listed in this section are eligible for payment. Nerve blocks
        listed elsewhere in the Schedule are not payable for acute pain management.
      2.For obstetrical continuous conduction anaesthesia, see P014C and P016C, listed in the
        Obstetrics section.]
  7. With the exception of a bilateral pudendal block (where only one service is eligible for payment)
     a nerve block is payable once per region per side where bilateral procedures are performed.
  8. Notwithstanding maximums applicable to individual nerve block services, there is an overall
     maximum of 8 per patient per day for any combination of nerve blocks. The ninth and
     subsequent nerve blocks per patient per day are not eligible for payment. Nerve blocks which
     are defined as a bilateral procedure are counted as two services for the purpose of the overall
     daily maximum.
  9. Professional and/or technical fees for obtaining and/or interpreting images for the purpose of
     guidance (e.g. nerve stimulation, ultrasound, fluoroscopy) are not eligible for payment in
     addition to the injection services listed in this section.
  10. For anaesthesia services in support of a nerve block or interventional pain injection procedure
      performed by another physician, see General Preamble.
  11. Injection services listed elsewhere in the Schedule are not eligible for payment in addition to
      injections listed in this section for the same injection procedure.

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 493 / J79

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
 NERVE BLOCKS - PERIPHERAL/OTHER INJECTIONS
PREAMBLE
  1. With the exception of G224 as described in the Nerve Blocks for Acute Pain Management
     section, when a physician administers an anaesthetic, nerve block and/or other medication prior
     to, during, immediately after or otherwise in conjunction with a diagnostic, therapeutic or
     surgical procedure which the physician performs on the same patient, the administration of the
     anaesthetic, nerve block and/or other medication is not eligible for payment.
    2. Notwithstanding maximums applicable to individual nerve block services, there is an overall
       maximum of 8 per patient per day for any combination of nerve blocks. The ninth and
       subsequent nerve blocks per patient per day are not eligible for payment. Nerve blocks which
       are defined as a bilateral procedure are counted as two services for the purpose of the overall
       daily maximum.
    3. For anaesthesia services in support of a nerve block performed by another physician, see
       General Preamble.
    4. Professional and/or technical fees for obtaining and/or interpreting images for the purpose of
       guidance (e.g. nerve stimulation, ultrasound, fluoroscopy) are not eligible for payment in
       addition to the injection services listed in this section.
    5. Injection services listed elsewhere in the Schedule are not eligible for payment in addition to
       injections listed in this section for the same injection procedure.
    6. Topical anaesthesia or local infiltration used as an anaesthetic for any procedure is not eligible
       for payment.

PDF page 547 / SP5

A major or minor peripheral nerve block, major plexus block, neuraxial injection (with or without
        catheter) or intrapleural block (with or without catheter) for post-operative pain control (with a
        duration of action more than 4 hours) is eligible for payment as G224 when rendered in
        conjunction with a procedure which the physician performs on the same patient.
         [Commentary:
         For additional information, refer to the Nerve Blocks - Acute Pain Management, Nerve Blocks -
         Interventional Pain Injections or Nerve Blocks - Peripheral/Other sections of the Schedule.]
    21. If claims are being submitted in coded form, the surgeon should add the suffix A to the listed
        procedural code, the surgical assistant should add the suffix B to the listed procedural code and
        the anaesthesiologist should add the suffix C to the listed procedural code.
    22. When Z222/Z223 is claimed for a patient for whom the physician submits a claim for rendering
        another insured service on the same day, the amount payable for Z222/Z223 is reduced to nil.
    23. When a surgical procedure is attempted laparoscopically in the digestive system or the female
        genital system, but requires conversion to a laparotomy, unless otherwise specified, the
        diagnostic laparoscopic fee E860 is payable in addition to the procedural fee.

Master, record 1938. Record Layout PDF, page 1.

G22420250401999999990000015550000000000000000000000000000000000000000000000

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.