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Billing code

G918A — Caudal

Caudal epidural injection

Bill G918 for a percutaneous caudal epidural injection; add E440 when contrast is injected under fluoroscopy.

Watch for: G246, G117, G119 and G918 together are limited to 12 per 12 months; not payable with concurrent surgery.

Code

G918A

Description

Caudal

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

Percutaneous caudal epidural injection. Add-ons cover contrast with fluoroscopy, prior surgery level, transforaminal technique and catheters.

What it covers

G918 is a percutaneous epidural injection at the caudal level, listed under Epidural and spinal injections in the Interventional Pain Injections section (J76).

The fee includes the injection of medication or other solution; contrast injected under fluoroscopy is billed with the E440 add-on (J74, J76).

Billing rules

• G246, G117, G119 and G918 combined are limited to 12 per patient per 12 months; for more, get written prior authorization from the Ministry (J76).
• Same patient, same day as G920, G234 or G236 only if it diagnoses or treats a separate condition; a sympathetic block caused by the epidural is not billable as G920, G234 or G236 (J76).
• Not payable with any concurrent surgical procedure or any anaesthetic fee, except E030C or E031C for anaesthesia support (J76).
• Not payable with G919 (epidural adhesiolysis) for the same procedure for which G919 is paid (J77).
• Diagnostic pain injections are paid only when done solely to find the source of pain or to plan treatment (J74).
• Fees for obtaining or interpreting guidance images (professional or technical) are not payable on top of these injections (J74).
• The chart must describe the procedure (or, with image guidance, keep images of final needle placement showing the site and/or contrast spread) and, for a diagnostic injection, its purpose and whether the response was positive or negative (J74).
• Marked #: the fee does not include premises, equipment, supplies or staff; in hospital these are funded by the hospital budget, and patients can't be charged for them (GP13).

Often billed with

• E440 with contrast injection under fluoroscopy (J76).
• E441 when done at the level of previous spinal surgery (J76).
• E442 with a transforaminal technique (J76).
• E443 with a catheter for continuous infusion, or E833 with a subcutaneous port (J76).

Common rejections

• AM1: OHIP describes this as 'Service Limit Exceeded': more than 12 epidural injections (G246, G117, G119, G918 combined) in 12 months without Ministry prior authorization (J76).
• ASP: OHIP describes this as 'Not Allowed with Surgical Procedure': epidural injections are not payable with a concurrent surgical procedure (J76).

Related codes: G246, G117, G119, E440, E442, G248, G919

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

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