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Z446
Z446 – Insertion of subcutaneous venous access reservoir
OHIP Psychiatric Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Insertion of a subcutaneous venous access reservoir. This is a surgical procedure to implant a device under the skin for long-term access to a vein, often for chemotherapy, antibiotic therapy, or other infusions. This procedure is eligible for an add-on payment (E684) when performed on an infant or child. See .
When to Use
- Use Z446 for the primary insertion of a subcutaneous venous access reservoir (port-a-cath) for long-term infusion therapy.
- Use Z446 when the procedure is distinct from the insertion of an implantable central venous catheter (Z456), which involves a different device configuration.
Common Pitfalls
- Failing to append the E684 add-on code when performing this procedure on patients aged 29 days to 15 years, resulting in missed revenue.
- Attempting to bill Z446 alongside Z456 for the same anatomical site, which will trigger a rejection for duplicate or conflicting services.
- Neglecting to document the specific age-based premium eligibility, as these are calculated based on the patient's exact age at the time of the procedure.
Billing Tips
- Always verify the patient's age against the specific thresholds for age-based fee premiums (e.g., <30 days, 30 days-1 year) to ensure the correct percentage increase is applied to the base fee.
- If a surgical assistant is required, submit the claim with M400B and include a letter of medical necessity to the medical consultant to justify the assistant's presence.
Provider Fee$168.00
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures, Diagnostic and Therapeutic Procedures
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