Z319 – Antral puncture and/or lavage
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Z319 is a surgical procedure for antral puncture and/or lavage, which can be performed unilaterally or bilaterally. This service is designated as an Independent Operative Procedure (IOP). According to the note on , Z319 is not eligible for payment when rendered with any other surgical procedure by the same physician on the same patient, on the same day. As an IOP, specific payment rules apply when billed with other assessments on the same day (see ).
When to Use
- Use Z319 as the primary procedure for diagnostic or therapeutic antral lavage when no other surgical procedure is performed on the same patient by the same physician on that day.
- Use Z319 when performing a standalone antral puncture in an office or clinic setting for chronic sinusitis management, provided no other surgical codes are billed.
Common Pitfalls
- Billing Z319 alongside any other surgical procedure code will result in an automatic rejection, as it is strictly classified as an Independent Operative Procedure (IOP).
- Attempting to bill a full consultation or major assessment on the same day as Z319 will trigger a rejection if the major pre-operative visit occurred within the previous 12 months; only a minor or partial assessment is permitted.
Billing Tips
- If performing bilateral antral punctures, claim the procedure code in full, but ensure pre- and post-operative assessment benefits are claimed as if only one procedure occurred to comply with IOP payment adjustment rules.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
Z319 is not eligible for payment when rendered with any other surgical procedure by the same physician on the same patient, on the same day.
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