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Z414
Z414 – Injection of pericardial sclerosing agents
OHIP Psychiatric Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Injection of pericardial sclerosing agents. This is a cardiovascular surgical procedure performed on the heart and pericardium. As a listed surgical procedure, payment includes all constituent and common elements as defined in the General Preamble (, ). This includes pre-procedural evaluation on the day of the surgery, the surgical procedure itself, and normal post-operative care.
When to Use
- Use Z414 specifically for the therapeutic instillation of a sclerosing agent into the pericardial space to manage recurrent malignant pericardial effusions.
- Use this code when the procedure is performed as a standalone surgical intervention, as it is inclusive of all pre-procedural evaluation and post-operative care on the day of surgery.
Common Pitfalls
- Do not bill a separate consultation or assessment code on the same day as Z414, as the General Preamble dictates that pre-procedural evaluation is included in the surgical fee.
- Avoid billing Z414 in conjunction with diagnostic pericardiocentesis codes if the primary intent and action is the administration of the sclerosing agent, as the surgical fee is intended to cover the entire procedure.
Billing Tips
- Ensure that if the procedure is performed after hours or on weekends, you attach the appropriate E-series premium (E409 or E410) to the Z414 claim to capture the 50% or 75% increase, provided the procedure meets the non-elective criteria.
Provider Fee$23.10
Effective: April 1, 2025
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
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