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Z263
Z263 – Iliac bone graft
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Payable for the harvesting of a bone graft from the iliac crest. This service is claimed when a bone graft is required for a primary surgical procedure, but the harvesting of the graft is not an intrinsic component of that procedure. As noted on (), this contrasts with other procedures (e.g., R376, R391) which already include the graft harvesting.
When to Use
- Use Z263 when harvesting an iliac bone graft as an additional, distinct step for a primary orthopedic procedure that does not include graft harvesting in its own fee definition.
- Use Z263 when the primary procedure is a non-grafting surgery (e.g., complex fracture fixation) and a separate incision is required specifically to harvest autologous bone from the iliac crest.
Common Pitfalls
- Claiming Z263 with codes like R376 or R391 will result in automatic rejection, as these procedures already include the graft harvesting in their base fee.
- Billing Z263 alongside E932, E934, or E935 is prohibited; these codes are mutually exclusive and will trigger an audit or rejection.
- Failing to verify if the primary surgical code already includes graft harvesting (indicated by an asterisk in the Schedule) is a frequent cause of claim denials.
Billing Tips
- Z263 is a major invasive procedure, making it eligible for after-hours premiums (E409, E410) if the criteria for non-elective or emergency-delayed surgery are met.
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