E446 is only eligible for payment when injection of the joint must be repeated using any method of image guidance following a failed blind attempt(s) by the same or different physician. Professional and/or technical fees for obtaining and interpreting the images required for the purpose of guidance of the injection are not eligible for payment to any physician.
1. Use of intra-articular viscosupplementation agent for treatment of osteoarthritis is not supported by evidence. An example of a viscosupplementation agent is hyaluronic acid. See http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ohtas-reports-and-ohtac-recommendations/intra-articular-viscosupplementation-with-hylan-g-f-20-to-treat-osteoarthritis-of-the-knee
2. For percutaneous provocation vertebral discography, refer to J006 Discogram page E4.