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Z864
Z864 – Probing and dilation of duct, initial or repeat - General anaesthetic
OHIP Psychiatric Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Probing and dilation of the nasolacrimal duct is a manipulation procedure of the lacrimal tract. This service is performed under general anaesthetic and may be rendered as an initial or repeat procedure. The fee is applicable for either unilateral or bilateral treatment, as specified on page of the Schedule of Benefits.
When to Use
- Use Z864 for nasolacrimal duct probing and dilation when performed under general anaesthetic, regardless of whether the procedure is initial or repeat.
- Use this code for both unilateral and bilateral procedures, as the fee is inclusive of both scenarios.
Common Pitfalls
- Do not attempt to bill for an assistant (B suffix) with Z864, as assistance at surgery is explicitly ineligible for payment per GP85.
- Avoid billing Z864 for procedures performed under local anaesthetic or topical sedation; this code is strictly reserved for cases requiring general anaesthesia.
Billing Tips
- Ensure you apply the appropriate age-based premium (GP64) if the patient is under 16 years of age, as this is a surgical procedure in the K-Z range.
- If the procedure is performed on an emergency basis or after hours, verify eligibility for E409 or E410 premiums to maximize the procedural fee.
Provider Fee$200.00
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
OCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Ocular and Aural Surgical Procedures, Anaesthesiologists' Services
Probing and dilation of duct, initial or repeat - General anaesthetic - unilateral or bilateral
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