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Z404
Z404 – Splenic puncture and aspiration
OHIP Psychiatric Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits
Z404 is a surgical procedure for splenic puncture and aspiration, listed under the Haematic and Lymphatic system. Payment for this service is conditional upon obtaining material for examination. As with all insured services, it includes all common and specific elements for surgical procedures as defined in the Schedule of Benefits.
When to Use
- Use Z404 for diagnostic splenic fine-needle aspiration (FNA) performed to obtain cytological or histological material for pathological examination.
- Select Z404 when the primary intent of the procedure is the acquisition of splenic tissue or fluid for diagnostic purposes, rather than therapeutic drainage.
Common Pitfalls
- Billing Z404 when the aspiration attempt fails to yield any material for examination, as the code is strictly conditional on successful specimen acquisition.
- Confusing Z404 with diagnostic imaging codes; ensure the claim reflects the surgical procedure itself rather than the guidance (e.g., ultrasound) used to perform it.
Billing Tips
- Ensure the pathology report or clinical documentation explicitly confirms that material was obtained and sent for examination to support the claim in the event of an audit.
Provider Fee$100.45
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
R. Haematic and Lymphatic Surgical Procedures
Subcategory
HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Haematic and Lymphatic Surgical Procedures
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