All codes
E820
E820 – Biopsy of ureter and/or pelvis using ureteroscope
OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This service is for a biopsy of one or more sites in the ureter and/or pelvis using a ureteroscope, and is payable in addition to the fee for diagnostic ureteroscopy (Z628).
When to Use
- Use E820 when performing a biopsy of a suspicious lesion in the ureter or renal pelvis during a diagnostic ureteroscopy (Z628).
- Use E820 when obtaining tissue samples for pathology from the upper urinary tract while already performing the primary diagnostic procedure Z628.
Common Pitfalls
- Billing E820 as a standalone procedure; it is an add-on code and will be rejected if not submitted on the same claim as Z628.
- Attempting to bill E820 in conjunction with Z638, which is a restricted code and will cause a claim rejection.
- Failing to document the specific site of the biopsy, which is required to justify the additional procedural fee beyond the base Z628.
Billing Tips
- Ensure E820 is linked to the same diagnostic code as Z628 to avoid processing errors.
- Apply relevant age-based premiums or after-hours premiums (E409/E410) to the total procedural fee, as E820 is considered a surgical procedure for premium eligibility.
Provider Fee$53.35
Effective: April 1, 2026
Category
T. Urogenital and Urinary Surgical Procedures
Subcategory
UROGENITAL AND URINARY SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Urogenital and Urinary Surgical Procedures
Payable in addition to diagnostic ureteroscopy (Z628).
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