Z811 – Intravenous drug test for pain
OHIP Psychiatric Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
The rules for billing Z811, 'Intravenous drug test for pain', are governed by the General Preamble of the Schedule of Benefits. This includes constituent and common elements of insured services as outlined on pages -, and specific elements for anaesthesia services on page . The surgeon's fee (suffix A) covers the procedure, and the anaesthesiologist's fee (suffix C) is calculated based on base units plus time units. Assistant services (suffix B) are not payable for this procedure.
When to Use
- Use Z811 when performing a diagnostic intravenous infusion of a medication (such as lidocaine or ketamine) specifically to assess the patient's pain response in a clinical setting.
- Use Z811 for the procedural component of a pain-mapping trial where the intravenous administration is the primary insured service being rendered.
Common Pitfalls
- Do not attempt to bill Z811 with a surgical assistant suffix (B), as assistant services are explicitly non-payable for this procedure.
- Avoid billing Z811 as a standard office visit; it is a surgical procedure code and must be supported by operative notes detailing the infusion process and patient response.
Billing Tips
- Ensure the anaesthesiologist calculates their fee using the base units assigned to Z811 plus the total time units, as per the anaesthesia billing rules in the General Preamble.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
All insured services must be documented in appropriate records. The Act requires that the record 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.
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