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Z225

Z225Bone - needle biopsy

OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Bone - needle

When to Use

  • Use Z225 for percutaneous needle biopsy of bone where a core or fine-needle aspiration is performed to obtain a tissue sample for pathology.
  • Select Z225 when the procedure is limited to a needle biopsy; do not use this code if an open surgical biopsy or a formal resection is performed, as those require different surgical codes.

Common Pitfalls

  • Billing Z225 in conjunction with an office visit (A007A) for the same patient on the same day is generally disallowed unless the visit is for a separate, unrelated clinical issue.
  • Failure to document the specific anatomical site and the needle-based nature of the biopsy can lead to audit recovery if the claim is flagged for review against higher-value surgical codes.

Billing Tips

  • If the patient is under 16, ensure the age premium is applied to the Z225 fee to capture the mandatory percentage increase based on the specific age bracket.
  • For non-elective procedures performed after hours, ensure the correct premium (E409A or E410A) is appended to the Z225 claim to receive the 50% or 75% fee increase.
Provider Fee$72.35
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

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