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Z869

Z869Bone - core, punch

OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

A surgical procedure for obtaining a bone biopsy. This procedure is listed under 'SKULL AND MANDIBLE' as 'Bone - punch, simple' on page . It is distinct from Z870 (Bone - punch, x-ray control) and Z242 (Bone - open).

When to Use

  • Use Z869 for a simple, non-image-guided core or punch biopsy of the skull or mandible.
  • Use Z869 when the procedure is performed as a standalone diagnostic biopsy, distinct from an open surgical approach (Z242).

Common Pitfalls

  • Do not bill Z869 if the procedure is performed under X-ray or fluoroscopic guidance; use Z870 instead.
  • Avoid billing Z869 alongside a hospital admission assessment, unless it qualifies as the major pre-operative visit where the decision to operate was finalized.
  • Do not use Z869 for open surgical bone procedures; Z242 is the correct code for open bone surgery.

Billing Tips

  • Ensure the biopsy is strictly a 'punch' or 'core' procedure to justify the fee, as more extensive open procedures (Z242) carry different valuation.
Provider Fee$48.50
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

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