Z306 – Excision of middle turbinate concha bullosa - unilateral
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Excision of middle turbinate concha bullosa - unilateral is a surgical procedure to remove a pneumatized (air-filled) cavity within the middle turbinate of the nose. This service is designated with a 'Z' prefix, making it an Independent Operative Procedure (IOP), which has specific billing rules for pre-operative assessments (see ). The '#' prefix indicates that when performed in a hospital or an Integrated Community Health Services Centre (ICHSC), the premises, equipment, supplies, and personnel are funded by the hospital global budget or facility costs and are not billable to the patient (see ).
When to Use
- Use Z306 when performing a unilateral resection of a pneumatized middle turbinate that is causing nasal obstruction or obstructing the osteomeatal complex.
- Use this code specifically for the excision of the concha bullosa itself, distinct from a standard turbinoplasty or inferior turbinate reduction (e.g., R181 or R182).
Common Pitfalls
- Billing Z306 alongside other endoscopic sinus procedures without applying the 85% multiple procedure rule for the lesser procedure, which leads to automatic claim adjustments.
- Attempting to bill an office visit or consultation fee on the same day as Z306, which is prohibited under the Independent Operative Procedure (IOP) rules unless the visit is for a completely unrelated condition.
- Failing to document the laterality clearly, as Z306 is strictly unilateral; bilateral procedures require the use of the bilateral indicator or separate line items with appropriate modifiers.
Billing Tips
- Ensure that if you perform a bilateral concha bullosa excision, you bill Z306 twice with the appropriate bilateral modifier or site-specific indicators to trigger the correct payment calculation.
- Verify that the procedure is not bundled into a more comprehensive sinus surgery code (e.g., FESS procedures) to avoid 'unbundling' audits where the Ministry considers the excision part of the primary surgical approach.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
Listed benefit is for unilateral procedure only.
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