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Z403
Z403 – Bone marrow aspiration and/or core biopsy
OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Bone marrow aspiration and/or core biopsy is listed as both a surgical procedure under Haematic and Lymphatic Surgical Procedures () and a diagnostic procedure under Laboratory Medicine (). Payment Rule: If the procedure does not result in any material for examination, the service is not eligible for payment.
When to Use
- Use Z403 when performing a bone marrow aspiration and/or a core biopsy for diagnostic purposes.
- Use Z403 instead of Z404 when the procedure is limited to the aspiration and/or biopsy, as Z404 is specifically for bone marrow trephine biopsy.
Common Pitfalls
- Submitting a claim for Z403 when the procedure fails to yield a sample; the service is strictly non-payable if no material is obtained for examination.
- Attempting to bill Z403 in conjunction with a consultation or assessment on the same day without ensuring the procedure is distinct and documentation supports the separate service.
Billing Tips
- Ensure the pathology report confirms the successful collection of material, as this is the primary audit trail for the eligibility of the fee.
- If the procedure is performed after hours or on weekends, apply the appropriate E409 or E410 premium to the Z403 fee, provided the criteria for non-elective or emergency-delayed procedures are met.
Provider Fee$133.55
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
Effective: April 1, 2026
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Surgical
Code Classes
Haematic and Lymphatic Surgical Procedures, Diagnostic and Therapeutic Procedures
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