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Z904
Z904 – Local excision, polyp - office
OHIP Psychiatric Code — AURAL SURGICAL PROCEDURES · Schedule of Benefits
Local excision of a polyp of the external ear performed in an office setting. As per the and of the Schedule of Benefits, this service includes all common elements of an insured service, such as making appointments, history taking, record keeping, and providing the necessary premises and supplies for the procedure in an office setting.
When to Use
- Use Z904 for the simple, localized excision of an aural polyp performed in a standard office setting.
- Select Z904 when the procedure is limited to the external ear, distinguishing it from more complex surgical interventions or procedures involving the middle ear.
Common Pitfalls
- Do not bill Z904 in conjunction with a general office visit fee (e.g., A007) as the procedure code is considered to include the visit elements.
- Avoid using Z904 for procedures requiring general anesthesia or those performed in a hospital operating room, as this code is specific to the office setting.
Billing Tips
- Ensure the procedure is documented as a 'local excision' to justify the use of Z904 over more extensive surgical codes like Z905.
- If the patient is under 16 years of age, remember to append the appropriate age-based premium to the Z904 claim to maximize the procedural fee.
Provider Fee$25.85
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
AURAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Ocular and Aural Surgical Procedures
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