Z220 – Biopsy - needle/punch, x-ray control
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z220 is a surgical procedure for a needle or punch biopsy of bone, specifically from the shoulder, arm, or chest wall, performed under x-ray control. This service is part of the Musculoskeletal System Surgical Procedures section. The fee is for the surgical component (suffix 'A'). An anaesthesia service (suffix 'C') is separately billable with 6 basic units. Assistance at surgery (suffix 'B') is not an eligible service for this procedure. See for details. This service is subject to general surgical payment rules and may be eligible for various premiums such as age-based premiums (), after-hours procedure premiums (), and the trauma premium ().
When to Use
- Use Z220 specifically for needle or punch biopsies of bone located in the shoulder, arm, or chest wall when fluoroscopic or radiographic guidance is required.
- Select Z220 over Z219 when the procedure involves the specific anatomical regions of the shoulder, arm, or chest wall rather than other musculoskeletal sites.
Common Pitfalls
- Billing Z220 with an assistant (suffix B) will result in an automatic rejection, as this procedure is not eligible for assistance at surgery.
- Failing to include the required x-ray control documentation in the procedure note will lead to clawbacks during an audit, as the guidance is a mandatory component of this code's definition.
Billing Tips
- Ensure you bill the anaesthesia component separately using suffix C with 6 basic units to capture the full value of the procedure.
- Always verify if the procedure qualifies for the trauma premium (GP109) if performed in an emergency setting, as this is often overlooked for musculoskeletal biopsies.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in the patient's medical record, establishing that the service was provided, is the service submitted for payment, and was medically necessary, as per .
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