Z428 – Pacemaker lead extraction
OHIP Psychiatric Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This service is for the extraction of a pacemaker lead, which can be performed with or without the use of extraction sheaths, laser, or similar technology. - For each additional lead extracted during the same procedure, claim E628. - The surgeon's fee is claimed with suffix A (Z428A). - The assistant's fee is claimed with suffix B (Z428B) and is based on 10 base units plus time units as described on pages -. - The anaesthetist's fee is claimed with suffix C (Z428C) and is based on 7 base units plus time units as described on pages -.
When to Use
- Use Z428A for the primary extraction of a single pacemaker lead, regardless of whether manual traction or advanced tools like laser sheaths are required.
- Use Z428A in conjunction with E628 when multiple leads are removed during the same operative session to account for the additional complexity.
- Use Z428A for lead extraction necessitated by infection, lead failure, or system upgrade requirements.
Common Pitfalls
- Billing Z428A for the removal of a lead that is part of an ICD system, which may fall under different procedural codes depending on the specific device type.
- Failing to append the E628 code for secondary leads, which results in under-billing for the total operative time and technical effort involved.
- Incorrectly claiming the assistant (Z428B) or anaesthetist (Z428C) units without referencing the specific base unit requirements outlined in the General Preamble.
Billing Tips
- Ensure the operative report clearly distinguishes between the primary lead (Z428A) and any subsequent leads (E628) to justify the additional units claimed.
- Verify that the anaesthesia time units are calculated strictly according to the GP92-GP93 guidelines to avoid automatic rejection of the Z428C suffix.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.