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Z143
Z143 – Large core breast biopsy
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Large core breast biopsy - (14 gauge or larger bore needle). This is a surgical procedure listed under the Incision category for Operations of the Breast on page .
When to Use
- Use Z143 specifically for image-guided or palpation-directed core needle biopsies of the breast using a 14-gauge or larger needle.
- Use Z143 when performing a diagnostic biopsy of a suspicious breast lesion that requires a tissue sample larger than what is provided by a fine needle aspiration (FNA).
Common Pitfalls
- Billing Z143 in conjunction with a consultation or office visit on the same day is generally disallowed unless the visit is for an unrelated condition and clearly documented as such.
- Do not use Z143 for fine needle aspiration (FNA) procedures; FNA is billed under different codes, and using Z143 for smaller gauge needles will lead to audit discrepancies.
Billing Tips
- Ensure your operative report explicitly states the gauge of the needle used (14G or larger) to substantiate the use of Z143 over lower-level biopsy codes.
- If the procedure is performed in a hospital setting, verify that the facility fee is not being incorrectly bundled with your professional fee to avoid double-billing rejections.
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