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Z217
Z217 – Bone biopsy - under general anaesthetic
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs a biopsy of bone, under general anaesthetic. This surgical procedure is listed in the 'Pelvis and Hip' sub-section of the Musculoskeletal System Surgical Procedures section of the Schedule. The fee for the assistant surgeon (Z217B) requires authorization from a medical consultant. The fee for anaesthesia (Z217C) is based on 7 base units plus time units.
When to Use
- Use Z217 for a formal bone biopsy performed in an operating room setting under general anaesthesia when the procedure is specifically directed at the pelvis or hip.
- Select Z217 over Z212 or Z214 when the clinical requirement for general anaesthesia is documented, as Z217 is specifically designated for procedures requiring this level of sedation.
Common Pitfalls
- Failing to include a letter of medical necessity from the surgeon when billing for the assistant (Z217B) will result in automatic rejection, as this code requires individual consultant authorization.
- Incorrectly assuming the assistant fee is automatically payable; because Z217 lacks pre-defined assistant units, the claim must be manually reviewed to determine if the complexity justifies an assistant.
Billing Tips
- Ensure the anaesthesiologist claims the 7 base units plus the appropriate time units, and verify that all applicable ASA or patient-specific modifiers (e.g., E022C, E010C) are appended to the anaesthesia claim to maximize unit recovery.
- When billing the assistant fee, explicitly reference the requirement for the assistant in the surgical report to expedite the medical consultant's review process.
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