Z219 – Muscle needle biopsy, soft tissue, per site
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents an unspecified procedure from the Musculoskeletal System surgical section of the Schedule of Benefits. The master fee record provides a professional fee, but no fee for an assistant or anaesthetist, suggesting this service is typically performed without them. General payment rules for surgical procedures from the General Preamble apply, including eligibility for age-based fee premiums for patients under 16 years of age as per page . This procedure is not listed as a delegatable procedure and therefore must be rendered personally by the physician.
When to Use
- Use Z219 for a percutaneous needle biopsy of muscle tissue when a core or fine-needle aspiration is performed to obtain a diagnostic sample.
- Use this code for soft tissue biopsies where the procedure is limited to a needle-based approach, distinguishing it from open surgical biopsy codes like R034.
Common Pitfalls
- Billing Z219 in addition to a consultation or assessment on the same day is often rejected unless the biopsy was not the primary reason for the visit and is documented as a separate, distinct service.
- Attempting to bill Z219 multiple times for the same anatomical site is a common audit trigger; ensure you are billing per site as specified in the code description.
Billing Tips
- Ensure you apply the appropriate age-based fee premium (GP64) if the patient is under 16, as this is a surgical procedure in Part Z.
- Since Z219 is not delegatable, ensure the physician's billing number is explicitly linked to the procedure to avoid rejection for non-physician service.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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