Z202 – Hand
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Application of a cast, typically for fractures or dislocations. Per , this is a procedure that is generally and historically accepted as one which may be carried out by a nurse or other medical assistant in the employ of the physician. The rules for delegation are outlined in of the Schedule. Application of plaster casts or corrective splints are not to be claimed if applied at the time of surgery (except for the application of a cast brace) or applied during the first 2 weeks for a fracture or dislocation when a procedural fee is applicable. The subsequent application of plaster casts may be claimed according to the following Schedule.
When to Use
- Use Z202 for the subsequent application of a plaster cast to the hand following the initial two-week post-fracture or post-dislocation period.
- Use this code when a cast is applied by a nurse or medical assistant under delegation rules, provided the procedure is not part of the initial surgical management.
Common Pitfalls
- Billing Z202 within the first 14 days of a fracture or dislocation is a common rejection, as this period is covered by the global procedural fee for the initial reduction or treatment.
- Attempting to claim Z202 for a cast applied during the same encounter as a surgical procedure is prohibited, as the cast application is considered inclusive of the surgical fee.
Billing Tips
- Ensure that if the procedure is delegated to a staff member, the medical record explicitly identifies the staff member by name and includes a brief note of the procedure to comply with GP62 documentation requirements.
- Apply the 15% age premium for patients aged two to four years, as Z202 falls under the Part Z surgical procedures eligible for this increase.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Delegated Procedure
If the procedure is delegated, the medical record must be dated, identify the non-physician performing the service, and contain a brief note on the procedure performed by the non-physician.
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