Z401 – Aspiration of pericardium
OHIP Psychiatric Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Aspiration of pericardium is a therapeutic procedure to remove fluid from the pericardial space. This service is a surgical procedure and is subject to the general rules for surgery, including the common and specific elements of surgical services as outlined in the Schedule of Benefits. As per page , an admission assessment for a 'Z' prefix procedure is deemed a specific re-assessment if the patient was assessed prior to admission for the same illness.
When to Use
- Use Z401 for therapeutic pericardiocentesis performed to relieve cardiac tamponade or symptomatic pericardial effusion.
- Use Z401 when performing an aspiration for diagnostic fluid analysis in a patient with a known or suspected pericardial effusion.
- Use Z401 as the primary procedure code when the aspiration is the definitive surgical intervention performed during the encounter.
Common Pitfalls
- Billing a hospital admission assessment (A005) on the same day as Z401 is a common rejection; ensure you only bill the major pre-operative visit if the decision to operate was made previously.
- Attempting to bill Z401 alongside other surgical procedures without checking for 'General Preamble' multiple procedure rules, which may reduce the fee for the second procedure.
- Failing to document the specific trauma criteria (ISS score) when attempting to append the E420 trauma premium to this code.
Billing Tips
- If the procedure is performed after hours, ensure you apply E409 or E410 correctly, as these are 50% or 75% premiums respectively and cannot be combined with E420.
- Always verify if the patient was previously assessed for the same illness by you, as GP23 mandates that the admission assessment will be treated as a re-assessment rather than a new consultation.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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