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Z604
Z604 – Meatotomy and plastic repair
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Meatotomy and plastic repair, represented by billing code Z604, is a surgical procedure listed in the Urogenital and Urinary Surgical Procedures section of the Schedule of Benefits under 'Urethra' and 'Incision'. It involves making an incision (meatotomy) to widen the urethral meatus, followed by a plastic repair of the site. It is eligible for surgeon and anaesthetist fees, with 6 base units assigned for anaesthesia.
When to Use
- Use Z604 when performing a formal meatotomy specifically requiring a plastic repair (meatoplasty) to correct meatal stenosis.
- Use Z604 for the surgical enlargement of a stenotic urethral meatus where simple dilation (S530) is insufficient or ineffective.
Common Pitfalls
- Billing Z604 alongside simple urethral dilation (S530) is considered double-dipping, as the repair is inclusive of the incision.
- Attempting to bill a surgical assistant (B suffix) for Z604 will result in rejection, as this procedure does not qualify for assistant coverage under standard Schedule of Benefits rules.
- Failure to document the specific 'plastic repair' component can lead to audit reclassification to a lower-valued incision-only code if the repair is not clearly described.
Billing Tips
- Ensure the operative report explicitly describes the meatoplasty technique (e.g., V-Y advancement or tissue suturing) to justify the 'plastic repair' component of the code.
- Always apply the appropriate age-based surgical premium (e.g., AGE_PREMIUM_5Y_TO_16Y) to the Z604 fee, as this is a surgical procedure eligible for these modifiers.
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