Z443 – Insertion of temporary endocardial electrode
OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Insertion of temporary endocardial electrode. This is a surgical procedure that is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees. As a listed service, it includes all applicable common elements described in the Schedule of Benefits on pages -.
When to Use
- Use Z443 for the urgent placement of a temporary transvenous pacing wire in a patient experiencing symptomatic bradycardia or heart block.
- Select Z443 when performing a bedside temporary pacing lead insertion in the ICU or cardiac catheterization lab as a bridge to permanent pacemaker implantation.
Common Pitfalls
- Billing Z443 in conjunction with Z431 for the same procedure is considered unbundling and will result in a rejection.
- Failing to submit the required letter of justification from the surgeon when claiming the assistant fee (M400B) will lead to automatic denial of the assistant's claim.
- Attempting to bill Z443 as a minor procedure when it is classified as a surgical procedure, which may trigger audit flags if the associated facility and anaesthesia claims are missing.
Billing Tips
- Ensure the anaesthetist claims the 6 basic units associated with Z443 to align with the surgical assistant's unit calculation for consistency in the claim audit trail.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic and Therapeutic
Diagnostic and Therapeutic Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
Assistance at surgery (suffix B) is eligible for payment upon authorization by a medical consultant. This requires submission of a letter from the surgeon outlining the reason an assistant was required. Claims for this service must be submitted using fee code M400B.
The number of basic units for the surgical assistant fee is the same as the number of basic units for anaesthesia (6 units).
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