< Billing codes

Billing code

E440A

Epidural contrast with fluoroscopy

Add to an epidural injection (G246, G117, G119 or G918) when contrast is injected using fluoroscopy.

Watch for: Only payable with G246, G117, G119 or G918, and not with G919 for the same procedure.

Code

E440A

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Add-on to a lumbar, thoracic, cervical or caudal epidural injection when contrast is injected using fluoroscopy.

What it covers

E440 is added to a percutaneous epidural injection (G246, G117, G119 or G918) when contrast is injected using fluoroscopy (J76).

Injections in this section include contrast unless separately listed; for epidurals, contrast with fluoroscopy is separately listed as E440 (J74, J76).

Billing rules

• Only payable with G246, G117, G119 or G918 (J76).
• Example from the Schedule: an interlaminar lumbar injection at a previous surgical site, with contrast to confirm needle placement, that doesn't meet the G919 conditions is billed G246 + E440 + E441 (J77).
• Not payable with G919 for the same procedure for which G919 is paid (J77).
• The base epidural codes are limited to 12 per patient per 12 months combined without Ministry prior authorization (J76).
• Fees for obtaining or interpreting guidance images (professional or technical) are not payable on top of these injections (J74).

Often billed with

• G246, G117, G119 or G918 as the base epidural (J76).

Common rejections

• AD9: OHIP describes this as 'Premium not allowed alone': this add-on is paid only with G246, G117, G119 or G918 on the same claim; add the base code or remove the add-on.

Related codes: G246, G117, G119, G918, E441, E442, E443, E833

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Nerve Blocks - Interventional Pain Injections, page J76.

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