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Z466
Z466 – Device closure of two or more defects
OHIP Psychiatric Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Percutaneous transluminal catheter assisted closure for Secundum atrial septal defect, specifically for the closure of two or more defects using a device. This is a surgical procedure and requires suffix 'A' for the surgeon. Suffixes for assistant ('B') and anaesthetist ('C') are also applicable, with fees for these components determined as per the general preamble for surgical services without listed units.
When to Use
- Use Z466 specifically when the clinical documentation confirms the successful percutaneous closure of two or more distinct atrial septal defects using device technology.
- Select Z466 instead of Z465 when the procedural report explicitly details the deployment of multiple devices or the closure of multiple septal defects during the same operative session.
Common Pitfalls
- Billing Z466 when only a single defect is closed; this is a common audit trigger that should be billed under Z465 instead.
- Failure to append the mandatory 'A' suffix for the surgeon, which will result in an automatic rejection of the claim.
- Attempting to bill Z466 alongside Z465 for the same physician on the same day; the Schedule of Benefits limits the combined total of these codes to two services only when performed by two different physicians.
Billing Tips
- Ensure the operative report clearly quantifies the number of defects closed to justify the use of Z466 over the lower-valued Z465.
- Always verify the patient's age at the time of the procedure to apply the appropriate age-based percentage premium, as this code is frequently utilized in pediatric cardiovascular interventions.
Provider Fee$347.45
Effective: April 1, 2025
Since Oct 2005, this fee has increased 0.0% vs 51.4% CPI inflation
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
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