Z438 – Insertion of Swan-Ganz catheter
OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Insertion of Swan-Ganz catheter. This service is not included in anaesthetic, respiratory or critical care benefits. Note Z438 includes dye dilution densitometry and/or thermal dilution studies, when rendered (except in the setting of a cardiac catheterization laboratory). Commentary See G285 for dye dilution densitometry and G286 for thermal dilution studies performed using a Swan-Ganz catheter in a cardiac catheterization laboratory.
When to Use
- Use Z438 for the insertion of a pulmonary artery (Swan-Ganz) catheter in an ICU or bedside setting where the procedure is performed outside of a cardiac catheterization laboratory.
- Use Z438 when performing thermal dilution studies or dye dilution densitometry at the bedside, as these are considered included in the Z438 fee.
Common Pitfalls
- Do not bill G285 or G286 for thermal or dye dilution studies if the procedure was performed outside of a cardiac catheterization laboratory, as these are included in Z438.
- Avoid billing Z438 if the catheter insertion is performed as part of a surgical procedure where anaesthesia basic units are already being claimed, as the insertion is considered included in those units.
Billing Tips
- Ensure the claim clearly indicates the setting if audited, as the exclusion of cardiac catheterization laboratory services is the primary differentiator between Z438 and G285/G286.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
Z438 includes dye dilution densitometry and/or thermal dilution studies, when rendered (except in the setting of a cardiac catheterization laboratory).
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