Z252 – Manipulation - under general anaesthetic
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Manipulation of the hip or pelvis under general anaesthesia. A note clarifies that for manipulation performed without general anaesthetic, one should refer to the Diagnostic and Therapeutic Procedures - Physical Medicine section of the Schedule.
When to Use
- Use Z252 specifically for the manipulation of the hip or pelvis when the procedure is performed under general anaesthesia.
- Do not use Z252 for manipulations performed in an office or clinic setting without general anaesthesia; instead, refer to the Diagnostic and Therapeutic Procedures - Physical Medicine section of the Schedule.
Common Pitfalls
- Attempting to bill an assistant fee directly with Z252 suffix B will result in rejection; you must use M400B and provide a letter of justification to a medical consultant.
- Failing to document the exact start and stop times of the procedure in the patient's permanent record, which is a mandatory requirement for time-based anaesthesia and assistant services.
Billing Tips
- Ensure the procedure is clearly identified as occurring under general anaesthesia to distinguish it from physical medicine manipulation codes which are not eligible for the same surgical premiums.
- Verify that all applicable age-based premiums are applied to the Z252 fee if the patient meets the specific age criteria (e.g., under 30 days, 30 days to 1 year, etc.).
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For time-based anaesthesia and assistant services, the physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
Without general anaesthetic, see Diagnostic and Therapeutic Procedures - Physical Medicine.
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