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M138 – Hilar lymph node or lung biopsy with full thoracotomy

OHIP Respiratory Surgical Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

Hilar lymph node or lung biopsy with full thoracotomy is a surgical procedure to obtain tissue samples for diagnosis. This service is not an Independent Operative Procedure (IOP) and its fee includes the associated pre-operative and post-operative care as defined in the Surgical Preamble (see ), such as pre-operative hospital visits 1 or 2 days prior to surgery and post-operative care for up to two weeks (excluding the first two post-operative visits). The major pre-operative visit where the decision to operate is made can be billed separately.

This procedure is not a 'Z' code. The surgical fee includes pre-operative hospital visits which take place 1 or 2 days prior to surgery, and post-operative care and visits associated with the procedure for up to two weeks post-operatively, except for the first and second post-operative visits.

When a second assistant is required, the service is only eligible for payment following authorization by a medical consultant and requires submission of a letter from the surgeon outlining the reason.

Anaesthesia extra units for patient age, BMI, position, malignant hyperthermia risk, ASA status, and emergency status may be applicable as per .

Age-based premiums for patients under 16 years of age are applicable to the surgeon and assistant fees as per .

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