G260

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 485 / J71

Neuraxial
# G248 Caudal, single injection...........................................................      55.00
# G125 Caudal/lumbar epidural with catheter .....................................              100.00
# G118 Thoracic epidural with catheter...............................................          130.00
# G062 Cervical epidural with catheter................................................         160.00
  G260 Major plexus block ..................................................................    80.00
          Payment rules:
          1. The G260 service is a block of one of the following: brachial plexus, lumbar plexus, sacral
            plexus, deep cervical plexus, or a combined 3-in-1 block which must include the femoral,
            obturator and lateral femoral cutaneous nerves.
          2. When a major plexus block is rendered, additional blocks of one or more nerves within the
            same nerve distribution are not eligible for payment.
          [Commentary:
          If a peripheral nerve block is performed that is not within the same nerve distribution of a major
          plexus block, then both blocks are eligible for payment. For example, a sciatic nerve block
          performed in addition to a combined 3-in-1 block.]
          3. When 2 or more nerve blocks of major and/or minor peripheral nerves that are within the
            distribution of a major plexus are rendered individually, only G260 is eligible for payment.
          [Commentary:
          For example, if radial, median and ulnar nerve blocks are performed individually, only the
          brachial plexus block (i.e. major plexus block) is eligible for payment. If femoral, obturator and
          lateral femoral cutaneous blocks are performed individually, only the combined 3-in-1 (i.e.
          major plexus) block is eligible for payment.]
   G060 Peripheral nerve block, major .................................................         55.00
      Payment rules:
      1. The G060 service must consist of one of the following:
             a.a block of one of: radial, median, ulnar, musculocutaneous, femoral, sciatic, common
               peroneal and/or tibial, obturator, suprascapular, pudendal (uni or bilateral), trigeminal or
               facial nerve;
             b.a paravertebral block – first injection only;
             c.an ankle block (must include 2 or more of the following: deep peroneal, superficial
               peroneal, posterior tibial, saphenous or sural nerve); or
             d.a fascia iliaca block.
          2. G060 is limited to a maximum of 4 services per patient per physician per day.
          3. When a major peripheral nerve block is rendered, additional blocks of one or more nerves
            within the same nerve distribution are not eligible for payment.

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.]

Master, record 1974. Record Layout PDF, page 1.

G26020250401999999990000080000000000000000000000000000000000000000000000000

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.