What is OHIP billing code Z352?

Z352 is "Intrapleural administration of thrombolytic or fibrinolytic agent via thoracostomy tube", an OHIP Psychiatric code from the Ontario Schedule of Benefits (Physician Services).

How much does Z352 pay?

The current OHIP fee for Z352 is $50.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z352 to OHIP?

Z352 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z352 claims against the Schedule of Benefits rules before submission.

What codes are related to Z352?

Codes related to Z352 in the Schedule of Benefits include Z341, Z363.

All codes

Z352

Z352 – Intrapleural administration of thrombolytic or fibrinolytic agent via thoracostomy tube

OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

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Intrapleural administration of a thrombolytic or fibrinolytic agent via a thoracostomy tube (chest tube). This is classified as an Independent Operative Procedure (IOP), as indicated by the 'Z' prefix. As an IOP, specific payment rules apply regarding pre-operative assessments rendered on the same day (see ). This procedure is listed under the Respiratory Surgical Procedures section of the Schedule.

When to Use

Use Z352 specifically for the instillation of a fibrinolytic agent (e.g., tPA) into the pleural space via an existing thoracostomy tube to manage a complex pleural effusion or empyema.
Use this code when the procedure is performed as a distinct, non-elective intervention separate from the initial insertion of the chest tube (Z341).

Common Pitfalls

Billing Z352 on the same day as the initial chest tube insertion (Z341) may trigger a rejection or audit, as the instillation is typically a subsequent therapeutic step.
Attempting to bill a consultation or assessment code on the same day as Z352 will result in a rejection, as Z352 is an Independent Operative Procedure (IOP) that precludes same-day assessment billing by the same physician.
Failing to document the specific fibrinolytic agent used and the clinical indication for the intrapleural administration, which is required to justify the procedure during a post-payment review.

Billing Tips

If the procedure is performed after hours or on weekends, ensure you append the appropriate E-code (E409 or E410) to the Z352 claim to receive the percentage-based premium, provided the non-elective criteria are met.
If multiple instillations are required over several days, bill Z352 for each day the procedure is performed, ensuring the date of service reflects the actual administration time.

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Provider Fee$50.00

Effective: April 1, 2025

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