Z325 – Emergency tracheotomy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Emergency tracheotomy. This is an Independent Operative Procedure (IOP). Note: 1. Z325 is eligible for payment only for life-threatening emergency situations where the patient is not intubated. 2. Percutaneous tracheostomy, cricothyroidotomy or other emergency airway punctures do not constitute Z325.
When to Use
- Use Z325 for an open surgical tracheotomy performed in a life-threatening airway obstruction where the patient is not intubated.
- Use this code when the clinical urgency necessitates an open surgical approach rather than a percutaneous tracheostomy or cricothyroidotomy.
Common Pitfalls
- Billing Z325 for a cricothyroidotomy or percutaneous tracheostomy will result in rejection, as these are explicitly excluded by the Schedule of Benefits.
- Attempting to bill an assessment code on the same day as Z325 by the same physician is restricted; if the major pre-operative assessment is performed the same day, no other assessment is eligible.
- Failing to explicitly document the 'not intubated' status in the operative note is a common audit trigger that leads to recovery of funds.
Billing Tips
- Because Z325 is an Independent Operative Procedure (IOP), ensure you do not bill it with other procedures unless you are prepared to apply the 85% multiple procedure rule for secondary surgeries.
- Maximize your claim by appending appropriate After Hours Procedure Premiums or Special Visit Premiums (Table I or III) if the procedure occurs outside standard hours in the ED or hospital.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
Must document that the service was performed for a life-threatening emergency situation.
Must document that the patient was not intubated prior to the procedure.
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