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Z264
Z264 – Rib graft - one rib
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This procedure involves the surgical harvesting of one rib for the purpose of bone grafting. It is listed in the Schedule under Musculoskeletal System Surgical Procedures. Use this code for the first rib harvested. For each additional rib harvested during the same operation, see add-on code E975.
When to Use
- Use Z264 when harvesting a single rib as an autogenous bone graft for reconstructive procedures, such as spinal fusion or maxillofacial surgery.
- Use Z264 as the primary code for the first rib harvested, even if the primary surgical procedure (e.g., a spinal fusion) is billed separately.
Common Pitfalls
- Do not bill Z264 if the harvesting of the rib is already included in the description of the primary surgical procedure code, as this constitutes unbundling.
- Attempting to bill assistance (suffix B) or anaesthesia (suffix C) with Z264 will result in rejection, as the Schedule of Benefits assigns no basic units for these services to this code.
Billing Tips
- Always append E975 for each additional rib harvested beyond the first to ensure you are compensated for the increased surgical time and complexity.
- If the procedure is performed on a patient under 16, ensure the age premium is applied, as Z264 is eligible for the percentage increase under Parts K to Z of the Schedule.
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