S236 – Linear or radial echo-endoscope - excluding biliary or pancreatic examination
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service describes an endoscopic ultrasound performed using a linear or radial echo-endoscope. The scope used for this procedure may also be used for therapeutic procedures. This specific code is for examinations that exclude the biliary or pancreatic systems. The amount payable for an upper and/or lower GI endoscopy rendered in conjunction with S236 is zero, unless the GI endoscopy is necessary due to limited visualization with the echo-endoscope.
When to Use
- Use S236 for endosonographic evaluation of mediastinal or esophageal masses where the biliary or pancreatic systems are not the target of the examination.
- Use this code for the assessment of subepithelial lesions in the gastric wall when the procedure does not involve the biliary or pancreatic ducts.
Common Pitfalls
- Billing an upper GI endoscopy (e.g., Z500 series) on the same claim as S236 will result in a zero-dollar payment for the endoscopy unless you provide explicit documentation that the endoscopy was required due to limited visualization with the echo-endoscope.
- Attempting to bill S236 for procedures involving the biliary or pancreatic systems is a billing error; these must be billed under S237 instead.
- Failing to include the appropriate add-on codes (E802, E804, E805) when performing interventions during the S236 procedure results in significant under-billing, as these are not bundled into the base fee.
Billing Tips
- Always append the relevant add-on codes (E802 for biopsies, E804 for injections, or E805 for pseudocyst drainage) to the same claim as S236 to ensure the full procedural scope is captured.
- If you must perform a standard endoscopy alongside S236, ensure your operative report clearly justifies why the echo-endoscope provided limited visualization, as this is the only condition that allows for separate payment of the endoscopy.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
The amount payable for S236 when rendered in conjunction with S237 is zero.
The amount payable for upper and/or lower GI endoscopy rendered in conjunction with S236 or S237 is zero unless the upper and/or lower GI endoscopy is required due to the limited visualization with the linear or radial echo-endoscope.
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