Z742 – Phrenicotomy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Phrenicotomy is the surgical division of the phrenic nerve. As an Independent Operative Procedure (IOP), the fee for this service includes pre-operative and post-operative care. If the major pre-operative visit was rendered in the previous 12-month period, only a minor or partial assessment is eligible for payment on the same day. If the major pre-operative assessment is on the same day as the IOP, no other assessment is payable. See for full IOP rules.
When to Use
- Use Z742 when performing a surgical division of the phrenic nerve as a standalone procedure in a clinical setting.
- Apply this code when the procedure is performed as an Independent Operative Procedure (IOP) where the surgical fee is intended to encompass the associated pre-operative and post-operative care.
Common Pitfalls
- Billing a full consultation or major assessment on the same day as Z742 will result in an automatic rejection, as these are bundled into the IOP fee.
- Failing to apply the 15% reduction rule (as per SP3) when performing Z742 alongside another surgical procedure during the same hospitalization or within 14 days.
- Attempting to claim a separate pre-operative assessment fee when the major assessment occurred on the same day as the procedure.
Billing Tips
- If the major pre-operative assessment was completed within the previous 12 months, ensure you only bill a minor or partial assessment code on the day of the procedure to avoid claim rejection.
- If the procedure is non-elective and commences between 00:00h and 07:00h, remember to append the E410 premium to capture the 75% increase on the Z742 fee.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
An operative report must be included in the medical record.
General medical record requirements as per must be met.
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