Z204 – Removal of plaster
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service involves the removal of plaster. As per the Schedule of Benefits, this procedure is listed under the Musculoskeletal System surgical procedures. It is not eligible for payment if associated with fractures or dislocations within 2 weeks of initial treatment. This procedure is identified as a service that can be delegated to a trained employee in a physician's office under specific conditions outlined in the General Preamble on pages and .
When to Use
- Use Z204 for the removal of a plaster cast applied for non-fracture conditions, such as post-operative immobilization or soft tissue support, provided it is outside the 2-week post-treatment window.
- Use Z204 when a patient presents for cast removal after the initial 2-week period following a fracture or dislocation, as the removal is no longer considered part of the global fracture care fee.
Common Pitfalls
- Billing Z204 within 14 days of the initial fracture or dislocation treatment is a common rejection, as this is considered inclusive in the global fee for the initial procedure.
- Failing to document the name of the staff member who performed the removal when delegating the task, as required by the General Preamble GP62-63, will lead to audit recovery.
Billing Tips
- Ensure the medical record explicitly states the date and the specific procedure performed to satisfy the documentation requirements for delegated services.
- If the patient is under 16 years of age, remember to apply the appropriate age-based fee premium to the Z204 base fee to maximize the claim value.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Delegated Procedure
When this procedure is delegated to a non-physician, the medical record must be dated, identify the non-physician performing the service, and contain a brief note on the procedure performed.
All insured services must be documented in the medical record to establish that the service was provided, is the service submitted for payment, and was medically necessary.
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