Z245 – Biopsy for malignant hyperthermia, three or more
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is a surgical procedure listed in the Integumentary System Surgical Procedures section of the Schedule of Benefits. General rules for surgical procedures apply, including those for surgeon (suffix A) and anaesthetist (suffix C) services. Surgical assistant services (suffix B) are not payable for this code. Admission assessments for 'Z' prefix codes rendered by the surgeon are subject to specific rules (see , ).
When to Use
- Use Z245 specifically when performing an open muscle biopsy to obtain three or more samples for malignant hyperthermia diagnostic testing.
- Use this code when the procedure is performed in an operating room setting as part of a formal diagnostic workup for suspected susceptibility.
Common Pitfalls
- Attempting to bill for a surgical assistant (suffix B) will result in automatic rejection as this code is explicitly ineligible for assistant fees.
- Billing a hospital admission assessment separately is a common audit trigger; ensure you only claim the major pre-operative visit if the decision to operate was made at that time.
- Confusing Z245 with general muscle biopsy codes; Z245 is specific to the malignant hyperthermia protocol and requires the collection of three or more samples.
Billing Tips
- Ensure the operative report clearly documents the collection of three or more distinct muscle samples to justify the use of Z245 over generic biopsy codes.
- If the procedure is performed after hours for a non-elective indication, ensure the start time is documented to support the application of E409 or E410 premiums.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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