What is OHIP billing code Z405?

Z405 is "Anterior cervical lymph node(s), unilateral", an OHIP Psychiatric code from the Ontario Schedule of Benefits (Physician Services).

How much does Z405 pay?

The current OHIP fee for Z405 is $186.90, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z405 to OHIP?

Z405 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z405 claims against the Schedule of Benefits rules before submission.

What codes are related to Z405?

Codes related to Z405 in the Schedule of Benefits include Z411, Z406, R910, R915.

All codes

Z405

Z405 – Anterior cervical lymph node(s), unilateral

OHIP Psychiatric Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits

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This code represents the surgical biopsy of one or more anterior cervical lymph nodes on a single side. It is classified under the BIOPSY subsection of LYMPH CHANNELS within HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES. The service fee for the surgeon is a flat rate, while fees for an assistant (suffix B) and anaesthetist (suffix C) are calculated using a unit-based system. This system combines 6 base units (as per ) with time units, which are detailed in the General Preamble for surgical assistants (-) and anaesthetists (-).

When to Use

Use Z405 for an open surgical biopsy of anterior cervical lymph nodes when the procedure is confined to one side of the neck.
Select Z405 when performing a diagnostic lymph node excision that does not meet the criteria for a more extensive neck dissection or radical lymphadenectomy.

Common Pitfalls

Do not bill Z405 bilaterally; if nodes are biopsied on both sides, you must use Z406 for the contralateral side or appropriate bilateral modifiers if applicable.
Avoid billing Z405 in conjunction with Z411 (excision of cervical lymph nodes, radical) for the same anatomical site, as this will be rejected as a duplicate or inclusive service.
Failure to document the specific side of the biopsy can lead to audit discrepancies, as Z405 is strictly defined as unilateral.

Billing Tips

Ensure that if an assistant or anaesthetist is involved, their claims are submitted with the correct base units (6) plus time units to avoid payment delays.
If the biopsy is performed as a non-elective procedure during after-hours, ensure you append the correct E-code (E409 or E410) to the Z405 claim to capture the 50% or 75% premium.

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Provider Fee$186.90

Surgical Assistant Fee$75.06

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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