< Billing codes

Billing code

G869A — Botulinum Toxin Injection(s) Of Bladder Detrusor Muscle

Bladder Botox injection

Bill G869 for botulinum toxin injections into the bladder for overactive bladder unresponsive to at least 3 months of other treatment.

Watch for: One treatment per 12 weeks; repeats need the response to earlier treatment documented in the chart.

Code

G869A

Description

Botulinum Toxin Injection(s) Of Bladder Detrusor Muscle

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

Botulinum toxin injection(s) into the bladder detrusor muscle for refractory overactive bladder. One treatment per 12 weeks.

What it covers

G869 is botulinum toxin injection(s) of the bladder detrusor muscle (J51). It covers all injections needed to deliver the total dose of one treatment recommended in current guidelines (J51).

It is only payable for symptomatic refractory overactive bladder that has not responded to at least three months of behavioural modification or anticholinergics (J51).

Billing rules

• Only for refractory overactive bladder after at least 3 months of failed behavioural or anticholinergic treatment (J51).
• One G869 per patient per day, covering all injections for the treatment (J51).
• One treatment per patient every 12 weeks; more often needs manual review with supporting documentation (J51).
• Repeat treatments are payable only if the patient's response to earlier G869 treatments is documented in the chart (J51).
• Diagnostic cystoscopy Z606 can be billed with G869 if performed (J51).
• Botulinum toxin for indications not listed is not insured (J52).
• Diagnostic and therapeutic procedures are payable in addition to a consultation or assessment (J3).

Often billed with

• Z606 cystoscopy, if performed (J51).

Common rejections

• AM1: OHIP describes this as 'Service limit exceeded': G869 is limited to one treatment per patient every 12 weeks; if more frequent treatment is needed, resubmit for manual review with documentation (J51).

Related codes: Z606, Z607, E784, G875

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Injections or Infusions, page J51.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing