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Z291
Z291 – Application Pavlik Harness or DDH Splint
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the application of a Pavlik Harness or a Congenital Dislocation of the Hip (C.D.H.) splint. It is listed under surgical procedures for the musculoskeletal system, specifically for congenital hip conditions. As a Z-prefix procedure, specific rules apply regarding admission assessments when performed in a hospital setting (see , ).
When to Use
- Use Z291 for the initial application of a Pavlik harness or DDH splint in an outpatient or clinical setting for a patient diagnosed with developmental dysplasia of the hip.
- Use Z291 when performing a follow-up adjustment or re-application of the harness if the clinical encounter meets the definition of a procedural service rather than a simple office assessment.
Common Pitfalls
- Billing Z291 in conjunction with a consultation or assessment code (e.g., A007) for the same encounter is often rejected or flagged as unbundling; ensure the service is billed as a procedure.
- Failing to apply the correct age-based premium (e.g., under 30 days or 30 days to 1 year) results in significant underpayment, as these premiums are not automatically calculated by the system.
Billing Tips
- Always verify if the patient meets the criteria for age-based premiums (GP64) as Z291 is a surgical procedure code and qualifies for these percentage increases.
- If the application occurs during an emergency or after-hours window, ensure you append the appropriate E409 or E410 premium, provided the procedure meets the non-elective criteria.
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