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Billing code

E446A — Injection joint with image guidance (foll. A failed attempt without imaging) add to G370/G371

Image-guided repeat joint injection

Add to G370 or G371 when a joint injection is repeated with image guidance after one or more failed blind attempts.

Watch for: Only as an add-on to G370 or G371; fees for obtaining or interpreting the guidance images aren't payable.

Code

E446A

Description

Injection joint with image guidance (foll. A failed attempt without imaging) add to G370/G371

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 G370 or G371 when a peripheral joint injection is repeated under image guidance after a failed blind attempt. Guidance imaging isn't paid.

What it covers

E446 is an add-on to G370 or G371 for a peripheral joint injection done with image guidance after a failed blind attempt (J53). It pays for the repeat, image-guided injection; the failed blind attempt may have been yours or another physician's (J53).

Billing rules

• Payable only when the joint injection has to be repeated using any method of image guidance after one or more failed blind attempts, by the same or a different physician (J53).
• Payable only as an add-on to G370 or G371 (J53).
• Professional and technical fees for obtaining and interpreting the guidance images are not payable to any physician (J53).
• The base code rules still apply: only one of G370, G371, G328 and G329 per bursa or joint, and none with a surgical procedure on the same site or area (J53).
• G370 and G371 are uninsured for injecting intra-articular viscosupplementation agents such as hyaluronic acid, so E446 has no insured base code for those injections (J53).
• FHO: not listed in Schedule 2 or 2A (core services), so not part of the base rate basket (Agreement pp.75–86).

Often billed with

• G370, or G371 for an additional joint: the injection E446 is added to (J53).
• E542 on the G370 line when the injection is done outside hospital (J53).
• A007 or another assessment the same day; procedures are payable in addition to an assessment (J3).
• FHO: Q012A with an after-hours A007A for an enrolled patient; the after-hours premium is paid on the listed visit codes, not on the procedure codes (Agreement p.68 §8.12).

Common rejections

• EQ6: OHIP describes this as 'Referring provider number not registered with the Ministry': a referring provider number on the claim isn't registered. Check or correct it, or leave it off if there was no referral.

Related codes: G370, G371, E542, G328, G329, G700

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Injections or Infusions, page J53

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