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Z427
Z427 – Sentinel node biopsy
OHIP Psychiatric Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits
Sentinel node biopsy, per draining basin. This is a surgical procedure listed under Haematic and Lymphatic Surgical Procedures. Payment for surgical assistant (B suffix) and anaesthesiologist (C suffix) services are calculated based on a combination of base units and time units as outlined in the to .
When to Use
- Use Z427 for the identification and excision of sentinel lymph nodes in breast cancer or melanoma cases where the node is identified via radioactive tracer or dye.
- Bill Z427 per draining basin; if sentinel nodes are harvested from multiple distinct basins (e.g., bilateral axillary basins), you may bill Z427 for each basin involved.
Common Pitfalls
- Billing Z427 as a single procedure when multiple basins are addressed; ensure each basin is clearly documented to support multiple claims.
- Confusing Z427 with standard lymph node dissection codes; Z427 is specifically for the sentinel node procedure and does not include the subsequent formal lymphadenectomy.
Billing Tips
- Always document the specific draining basin for each Z427 claim to prevent rejection during manual review or audit of multiple-basin procedures.
- Ensure the surgical report explicitly confirms the successful identification and removal of the sentinel node to validate the procedural fee.
Provider Fee$330.45
Surgical Assistant Fee$75.06
Anaesthetist Fee$123.92
Non-Anaesthetist Fee$123.92
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
Billed per draining basin.
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