Z316 – Posterior packing - unilateral or bilateral
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This service is for posterior packing of the nose for the treatment of epistaxis (nasal hemorrhage). The fee covers either unilateral or bilateral packing. As this is an Independent Operative Procedure (IOP) with a 'Z' prefix, specific rules apply. If the major pre-operative visit was rendered in the previous 12-month period by the same physician, only a minor assessment (by a GP) or a partial assessment (by a specialist) is eligible for payment on the same day prior to the IOP service. If the major pre-operative assessment is rendered on the same day as the IOP, no other consultation or assessment is eligible for payment prior to the service by the same physician on the same day (see ).
When to Use
- Use Z316 when posterior nasal packing is required for severe epistaxis, regardless of whether the packing is placed unilaterally or bilaterally.
- Use Z316 instead of Z315 (anterior packing) when the source of bleeding is posterior or when anterior packing fails to control the hemorrhage.
Common Pitfalls
- Attempting to bill an assessment code on the same day as Z316 will trigger a rejection, as Z316 is an Independent Operative Procedure (IOP) that bundles the pre-operative assessment.
- Billing Z316 in conjunction with Z315 for the same episode of care is redundant; Z316 is the higher-value procedure and is intended to cover the management of the hemorrhage.
- Failing to include the E839 add-on code when a flexible endoscope is used to guide the posterior packing results in lost revenue.
Billing Tips
- If you perform a flexible endoscopic examination to identify the bleeding site before placing the posterior pack, ensure you append E839 to Z316 to capture the additional $19.20 fee.
- If the procedure is performed after hours or on weekends, ensure you apply the appropriate E409 or E410 premium to the Z316 base fee, as these are compatible with this surgical code.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
The fee for Z316 applies whether the packing is unilateral or bilateral.
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