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Z425
Z425 – Bone marrow transplantation - aspiration from donor
OHIP Psychiatric Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits
This service covers the surgical aspiration of bone marrow from a donor and is part of the 'Bone marrow transplantation - team fee', which also includes Z426 (infusion into recipient). Commentary: Please refer to Cancer Care Ontario’s Guidelines at https://www.cancercareontario.ca/en/cancer-care-ontario/programs/clinical-services/specialized-services-oversight/stem-cell-transplant-program .
When to Use
- Use Z425 specifically for the surgical harvesting of bone marrow from a donor in a clinical setting.
- Use this code as the primary surgical fee when performing the aspiration component of a bone marrow transplant procedure.
Common Pitfalls
- Billing Z425 without ensuring the required pre-authorization for the transplant program is on file, which will lead to automatic rejection.
- Failing to link the procedure correctly to the transplant team fee structure, as Z425 is intended to be billed in conjunction with Z426 for the full transplant service.
Billing Tips
- Ensure the donor's health card information is used for the Z425 claim, as this service is distinct from the recipient's care.
- Verify that the procedure is performed within an approved Cancer Care Ontario facility to ensure compliance with specialized service oversight requirements.
Provider Fee$506.75
Anaesthetist Fee$123.92
Non-Anaesthetist Fee$123.92
Effective: April 1, 2025
Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category
R. Haematic and Lymphatic Surgical Procedures
Subcategory
HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Haematic and Lymphatic Surgical Procedures
Pre-Authorization Required
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