E674 – Gastroscopy - with snare polypectomy - 1st polyp > 1 cm
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the snare polypectomy of the first polyp that is greater than 1 cm in size. It is an add-on procedure and must be billed in conjunction with a primary gastroscopy service, specifically Z527, Z547, or Z528. This code is for the first large polyp only; see E675 for additional large polyps. Note: Z292 (laryngoscopy) rendered in association with gastroscopy services is not eligible for payment unless it is for suspicion of laryngeal disease. Claims for Z292 in these circumstances require manual review with a written explanation.
When to Use
- Use E674 when performing a snare polypectomy on the first gastric polyp measuring greater than 1 cm during a gastroscopy (Z527, Z547, or Z528).
- Use E674 specifically for snare techniques; do not use this code for biopsy or removal of polyps 1 cm or smaller, which are typically included in the base gastroscopy fee.
Common Pitfalls
- Billing E674 more than once per patient per day; only the first large polyp is eligible for this code, while subsequent large polyps must be billed using E675.
- Attempting to bill E674 without an associated primary gastroscopy service (Z527, Z547, or Z528), which will result in an automatic rejection.
- Confusing E674 with biopsy codes; ensure the procedure performed was a snare polypectomy for a lesion exceeding 1 cm as documented in the operative report.
Billing Tips
- Always document the size of the polyp in the procedure note to justify the use of E674 over standard biopsy or smaller polypectomy codes.
- If multiple polyps greater than 1 cm are removed, bill one unit of E674 for the first polyp and use E675 for each additional large polyp removed during the same session.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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