Z621 – Dilatation of stricture - male, local anaesthetic
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
A therapeutic procedure involving dilatation of a stricture in a male patient under local anaesthetic. As a 'Z' prefix code, this service is subject to the general rules for surgical and diagnostic procedures outlined in the Schedule of Benefits. This includes rules regarding admission assessments, after-hours premiums, and age-based premiums.
When to Use
- Use Z621 for the mechanical dilatation of a urethral stricture in a male patient performed under local anaesthetic.
- Select Z621 when the procedure is performed as a standalone therapeutic intervention, distinct from diagnostic cystoscopy (Z606 or Z607).
Common Pitfalls
- Billing Z621 in conjunction with Z615 is prohibited as they are mutually exclusive codes for urethral procedures.
- Failing to document the specific use of local anaesthetic can lead to audit scrutiny, as the code explicitly requires it for the fee to be valid.
- Attempting to bill an office visit fee (A007) on the same day as Z621 is generally disallowed unless the visit is for a separate, unrelated clinical issue.
Billing Tips
- Ensure the medical record clearly justifies the medical necessity of the dilatation to support the Z621 claim during potential post-payment reviews.
- Apply the appropriate age-based premium (e.g., for patients under 16) to the Z621 fee, as it is classified as a surgical procedure under Part Z of the Schedule.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Procedure
Urogenital and Urinary Surgical Procedures, Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records. The record must establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Male
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