E634 – Bronchoscopy with selective endobronchial blocker or catheter insertion
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable in addition to `Z327` (flexible or rigid bronchoscopy) for the concurrent insertion of a selective endobronchial blocker or catheter.
When to Use
- Use E634 when performing a selective endobronchial blocker placement to facilitate one-lung ventilation during thoracic surgery in conjunction with Z327.
- Use E634 when inserting a specialized catheter for selective bronchial lavage or targeted sampling during a bronchoscopic procedure (Z327).
Common Pitfalls
- Do not bill E634 if the bronchoscopy (Z327) is performed immediately following thoracic surgery under the same anaesthetic, as the base procedure is ineligible.
- Avoid billing E634 on the same day as a major lung resection if a bronchoscopy was already performed by you in the preceding 3-week window, as the base code Z327 will be rejected.
- E634 is an add-on code; it will be rejected if submitted without an associated Z327 claim on the same service date.
Billing Tips
- Ensure the specific nature of the blocker or catheter is clearly documented in the operative report to support the E634 claim in the event of a post-payment audit.
- Remember that E634 is subject to the 85% multiple procedure rule if other surgical procedures are performed under the same anaesthetic.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Procedure
Respiratory Surgical Procedures
When bronchoscopy, flexible or rigid, is rendered in conjunction with laryngoscopy or oesophagoscopy, only the bronchoscopy is eligible for payment.
Bronchoscopy rendered by the same surgeon immediately following thoracic surgery under the same anaesthetic is not eligible for payment.
Bronchoscopy (including intraoperative bronchoscopy) rendered the same day as a major lung resection is not eligible for payment if a bronchoscopy has been rendered by the same physician to the same patient in the 3-week period preceding the major lung resection.
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