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E636

E636Broncho-alveolar lavage

OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

Payable in addition to flexible or rigid bronchoscopy (`Z327). This service is for performing a broncho-alveolar lavage for the purpose of diagnosing malignancy or for the diagnosis and/or treatment of infection. This service includes obtaining specimens suitable for differential cellular analysis. As an add-on code, it must be billed with Z327.

When to Use

  • Use E636 when performing a broncho-alveolar lavage during a Z327 procedure specifically to obtain specimens for malignancy or infection diagnosis.
  • Use this code when the clinical objective requires differential cellular analysis of the lavage fluid, distinguishing it from simple bronchial washings.

Common Pitfalls

  • Billing E636 without an accompanying Z327 claim will result in an automatic rejection, as it is strictly an add-on code.
  • Attempting to bill E636 alongside other diagnostic procedures like Z360 is prohibited and will trigger audit flags or payment denials.
  • Claiming E636 for routine suctioning or airway clearance without the specific intent of diagnostic specimen collection for malignancy or infection is an improper use of the code.

Billing Tips

  • Ensure your operative report explicitly documents the lavage technique and the specific diagnostic intent to support the E636 claim during a potential audit.
  • Always link E636 to the same diagnostic code used for the primary Z327 bronchoscopy to maintain consistency in your billing submission.
Provider Fee$50.00

Effective: April 1, 2025

Category

P. Respiratory Surgical Procedures

Subcategory

RESPIRATORY SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Respiratory Surgical Procedures

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