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Z435
Z435 – Insertion of permanent endocardial electrode(s)
OHIP Psychiatric Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Insertion of permanent endocardial electrode(s). This procedure is listed in the Cardiovascular Surgical Procedures section under Heart and Pericardium. It does not have listed basic units for anaesthesia or surgical assistance.
When to Use
- Use Z435 for the primary insertion of a permanent endocardial pacing lead during a pacemaker implantation procedure.
- Use Z435 when replacing a single lead that has failed or become dislodged, provided it is an endocardial approach.
Common Pitfalls
- Billing Z435 in conjunction with Z436 (Insertion of epicardial electrode) for the same lead is a duplicate claim error; ensure the approach matches the code.
- Failing to recognize that Z435 does not include basic units for surgical assistance, which may lead to under-billing if an assistant is required and eligible under separate guidelines.
Billing Tips
- If the procedure is performed on a patient under 16, ensure the age premium is applied to the Z435 fee to capture the 10-30% increase based on the specific age bracket.
Provider Fee$154.10
Effective: April 1, 2025
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
For the E420 trauma premium to be payable, the medical record must list the Injury Severity Score (ISS).
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