Z631 – Fine needle aspiration of renal transplant
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Fine needle aspiration of a renal transplant is a surgical procedure listed under Renal Transplantation Procedures. A note on page specifies that claims should be submitted on the recipient's claim, and these fees do not include immunosuppressive therapy, which is billed on a fee-for-service basis.
When to Use
- Use Z631 for a fine needle aspiration performed specifically to obtain a tissue sample from a renal transplant for diagnostic purposes.
- Use this code when performing the aspiration as a standalone surgical procedure, distinct from the initial transplant surgery or subsequent major surgical revisions.
Common Pitfalls
- Submitting the claim under the donor's health number instead of the recipient's health number, which will result in an automatic rejection.
- Attempting to bundle immunosuppressive therapy management into the Z631 fee; these must be billed separately as fee-for-service office visits or consultations.
- Failing to apply age-based premiums (e.g., for pediatric transplant recipients) which are eligible additions to this surgical procedure code.
Billing Tips
- Ensure the procedure is documented as a fine needle aspiration of the transplant specifically, as general biopsy codes are not interchangeable with this transplant-specific code.
- If the procedure is performed after hours or on weekends, verify eligibility for E409 or E410 premiums, as Z631 qualifies as a surgical procedure for these add-ons.
Effective: April 1, 2025
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
Submit on recipient's claim. These fees do not include immunosuppressive therapy which is on a fee-for-service basis.
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