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Z094
Z094 – Removal tissue expander injection port - general anaesthetic
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the removal of a tissue expander injection port when it is the sole procedure performed. This specific code is used when the procedure is conducted under general anaesthesia. This is distinct from Z095, which is for removal under local anaesthetic.
When to Use
- Use Z094 when the injection port of a tissue expander is removed under general anaesthesia as the sole surgical procedure.
- Use Z094 for patients requiring general anaesthesia due to medical necessity or patient intolerance, distinguishing it from Z095 which is strictly for local anaesthesia.
Common Pitfalls
- Billing Z094 when the removal is performed under local anaesthesia, which will trigger a rejection or audit risk as Z095 is the mandatory code for local procedures.
- Attempting to bill Z094 in conjunction with other surgical procedures on the same site, which may violate the 'sole procedure' requirement and lead to claim adjustments.
- Failing to use the correct suffix (A for surgeon, B for assistant, C for anaesthetist) which results in payment errors or rejection of the claim.
Billing Tips
- Ensure the anaesthetic type is clearly documented in the operative report to justify the use of Z094 over Z095 during a potential audit.
- Apply the appropriate age-based fee premiums to Z094 if the patient meets the specific age criteria, as this code is eligible for these surgical modifiers.
Provider Fee$75.45
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Integumentary System Surgical Procedures
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