What is OHIP billing code Z440?

Z440 is "Left heart - retrograde aortic", an OHIP Psychiatric code from the Ontario Schedule of Benefits (Physician Services).

How much does Z440 pay?

The current OHIP fee for Z440 is $208.50, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill Z440 to OHIP?

Z440 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates Z440 claims against the Schedule of Benefits rules before submission.

What codes are related to Z440?

Codes related to Z440 in the Schedule of Benefits include Z439, Z441, G296, G285, G286, G262, G263.

All codes

Z440

Z440 – Left heart - retrograde aortic

OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

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Left heart cardiac catheterization via a retrograde aortic approach. Cardiac catheterization procedures, such as Z439 to G288, include the insertion of the catheter (including cutdown and repair of vessels if rendered), catheter placement, contrast injection, imaging, and interpretation.

When to Use

Use Z440 when performing a diagnostic left heart catheterization specifically via the retrograde aortic approach.
Use this code for the primary left heart procedure when no other cardiac catheterization codes from the Z439-G288 range are performed in the same session.
Use Z440 as the primary code when multiple catheterization procedures are performed, ensuring subsequent procedures are billed at 50%.

Common Pitfalls

Billing Z440 alongside other cardiac catheterization codes (Z439-G288) at 100% is a common audit trigger; ensure additional procedures are reduced to 50%.
Attempting to bill separately for catheter insertion, contrast injection, or imaging, which are all explicitly included in the Z440 fee.
Failing to document the specific retrograde aortic approach, which is required to justify the use of Z440 over other left heart variants like Z441.

Billing Tips

When performing multiple procedures from the Z439-G288 range, list the highest-valued procedure at 100% and apply the 50% reduction to all subsequent procedures.
If a surgical assistant is required, you must submit a formal letter to the Ministry justifying the necessity of the assistant to receive payment for M400B.

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Provider Fee$208.50

Surgical Assistant Fee$104.25

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

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