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P056

P056Insertion of fetal shunt - chest to amniotic cavity

OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits

Insertion of a fetal shunt from the chest to the amniotic cavity. This service is listed under the 'Insertion of fetal shunt' sub-category within 'Maternal - Fetal Procedures'. Note: Per page , procedures listed under Maternal - Fetal Procedures are payable in addition to J149 Ultrasonic Guidance and/or `Z552` Diagnostic Laparoscopy, where applicable.

When to Use

  • Use P056 specifically for the placement of a thoracoamniotic shunt to treat fetal pleural effusions or hydrothorax.
  • Use this code when the procedure involves the direct insertion of a shunt from the fetal chest cavity into the amniotic space under ultrasound guidance.

Common Pitfalls

  • Failing to bill J149 for the required ultrasonic guidance, which is explicitly payable in addition to P056.
  • Incorrectly assuming P056 is inclusive of diagnostic imaging; always ensure J149 is submitted as a separate line item on the same claim.

Billing Tips

  • Always append the appropriate age premium (e.g., AGE_PREMIUM_LT30D) if the procedure is performed on a neonate, as P056 is a surgical procedure eligible for these modifiers.
Provider Fee$398.10
Surgical Assistant Fee$100.08
Anaesthetist Fee$123.92
Non-Anaesthetist Fee$123.92

Effective: April 1, 2025

Category

K. Obstetrics

Subcategory

OBSTETRICS

Service Type

Surgical

Code Classes

Obstetrics, Surgical Assistants' Services, Anaesthesiologists' Services

Procedures listed under Maternal - Fetal Procedures are payable in addition to J149 Ultrasonic Guidance and/or `Z552` Diagnostic Laparoscopy, where applicable.

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