Z434 – Transluminal coronary angioplasty - one or more sites on a single major vessel
OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Transluminal coronary angioplasty is a procedure to open blocked coronary arteries, involving one or more sites on a single major vessel. This fee schedule item covers the procedure for the first vessel. Additional vessels can be billed using the add-on code G262. If coronary anatomy is unknown beforehand, preliminary angiography may be claimed using G297 at 50% of its fee. Placement of a stent is billed separately with G298. As a surgical procedure, it is eligible for various after-hours and age-based premiums.
When to Use
- Use Z434 as the primary procedure code for the first major coronary vessel treated via transluminal angioplasty.
- Use Z434 in conjunction with G262 when performing angioplasty on a second or subsequent major coronary vessel during the same operative session.
- Use Z434 when performing angioplasty regardless of whether a stent (G298) is subsequently placed, provided the primary vessel intervention is the focus.
Common Pitfalls
- Claiming J058 on the same day as G298 will result in G298 being paid at nil; ensure you are not double-billing these services.
- Failing to document the unknown coronary anatomy when claiming G297 at 50% will lead to audit recovery, as this is a specific requirement for the partial fee.
- Attempting to bill an assistant using a standard suffix instead of submitting M400B on an independent consideration basis with a letter of explanation.
Billing Tips
- Always append G262 for each additional major vessel treated to ensure proper compensation beyond the base Z434 fee.
- If the procedure is non-elective and performed after hours, ensure you apply the appropriate premium (E409 or E410) to the Z434 fee to maximize the procedural reimbursement.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Surgical
Diagnostic and Therapeutic Procedures
If anatomy unknown at time of procedure, claim G297 at 50%.
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