What are the billing rules for Z403A?

Not eligible for payment if the procedure doesn't produce any material for examination (R1). Z-codes are independent operative procedures (IOP). If you did the major pre-operative visit in the prior 12 months, the only assessment payable the same day before the IOP is a partial assessment (specialist) or minor assessment (GP); if the major pre-op visit is the same day, no other assessment before it is payable (SP4 §13). Z-prefix codes in the D&T section follow the Surgical Preamble (J1).

< Billing codes

Billing code

Z403A — Bone Marrow Aspiration

Q: What is OHIP billing code Z403A?

Bone marrow aspiration and/or core biopsy, performed by the physician. Not payable if no material is obtained.

Q: What is Z403A often billed with?

L802 bone marrow interpretation (J64).

Bone marrow aspiration or biopsy

Bill for bone marrow aspiration, core biopsy, or both at one sitting, done by the physician.

Watch for: Not payable if no material is obtained; interpretation is billed separately, such as L802.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$133.55	$0.00	$0.00	$95.76	$95.76

Code: Z403A
Description: Bone Marrow Aspiration
FHO+ basket: Not in the FHO+ base rate basket (Schedule 2 or 2B).
Effective date: Apr 1, 2026
Termination date: No end date

Explanation

Updated October 26, 2026

Bone marrow aspiration and/or core biopsy, performed by the physician. Not payable if no material is obtained.

What it covers

Z403 covers bone marrow aspiration, core biopsy, or both at one sitting (J64, R1). It is listed under Laboratory Medicine (Haematopathology) in Diagnostic and Therapeutic Procedures and again under Spleen and Marrow in Haematic and Lymphatic Surgical Procedures.

Interpretation of the marrow is billed separately by the interpreting physician, e.g. L802 bone marrow interpretation (J64).

Billing rules

Not eligible for payment if the procedure doesn't produce any material for examination (R1).
Z-codes are independent operative procedures (IOP). If you did the major pre-operative visit in the prior 12 months, the only assessment payable the same day before the IOP is a partial assessment (specialist) or minor assessment (GP); if the major pre-op visit is the same day, no other assessment before it is payable (SP4 §13).
Z-prefix codes in the D&T section follow the Surgical Preamble (J1).
The surgical listing shows 6 anaesthesia basic units, so an anaesthetist's services may be claimed with suffix C (R1).

Often billed with

L802 bone marrow interpretation (J64).

Related codes: L802, L800, Z404, Z425, Z426

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Laboratory Medicine (Haematopathology), page J64; also Haematic and Lymphatic Surgical Procedures, Spleen and Marrow, page R1.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing