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E678
E678 – TBNA of lung mass
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Transbronchial needle aspiration (TBNA) of a lung mass. This is an add-on procedure payable in addition to bronchoscopy (`Z327). As a #-prefixed service, when performed in a hospital or an Integrated Community Health Services Centre (ICHSC), the provision of premises, equipment, supplies, and personnel is not an element of the service as it is funded by the facility (see ).
When to Use
- Use E678 exclusively as an add-on code when performing a transbronchial needle aspiration of a lung mass during a bronchoscopy procedure (Z327).
- Apply this code when sampling mediastinal or hilar lymph nodes or peripheral lung lesions via needle aspiration to obtain tissue for diagnostic pathology.
Common Pitfalls
- Billing E678 as a standalone service will result in an automatic rejection, as it is strictly an add-on procedure that requires Z327 on the same claim.
- Failing to account for the 85% multiple procedure rule when performing other surgical interventions during the same bronchoscopy session will lead to incorrect payment calculations.
- Attempting to bill E678 for simple bronchial washings or brushings, which are already included in the base Z327 fee, constitutes an audit risk for unbundling.
Billing Tips
- Ensure the claim includes both Z327 and E678; the primary procedure (Z327) should be listed first to establish the base for the add-on.
Provider Fee$104.00
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Respiratory Surgical Procedures
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