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Z431
Z431 – Repositioning of temporary endocardial electrode
OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Repositioning of temporary endocardial electrode is a cardiovascular procedure. As a surgical service, it is eligible for payment with suffixes for the operating surgeon (A), surgical assistant (B), and anaesthesiologist (C). The fee calculation for assistants and anaesthetists is based on a combination of basic units and time units as outlined in the Schedule of Benefits (see -).
When to Use
- Use Z431 specifically for the adjustment or repositioning of a temporary endocardial lead that has migrated or is providing suboptimal capture, distinct from the initial insertion (G176/G177).
- Use this code when the procedure is performed as a standalone therapeutic intervention to restore pacing function without requiring a new lead placement or generator change.
Common Pitfalls
- Billing Z431 alongside a new lead insertion (G176/G177) is a common error; the repositioning is typically considered inclusive of the primary procedure if performed during the same session.
- Failure to document the clinical necessity for the repositioning, such as specific threshold changes or radiographic evidence of lead migration, significantly increases audit risk.
Billing Tips
- Ensure that if the procedure is performed after hours or on weekends, you append the appropriate after-hours premium (E409 or E410) to the Z431 fee to maximize reimbursement for non-elective urgent repositioning.
Provider Fee$64.25
Surgical Assistant Fee$32.13
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Surgical
Code Classes
Diagnostic and Therapeutic Procedures
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