Z322 – Laryngoscopy with removal of foreign body
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Direct laryngoscopy with removal of a foreign body. This service is an Independent Operative Procedure (IOP). As an IOP, if the major pre-operative visit was rendered in the previous 12-month period by the same physician, only a minor assessment (for GPs) or partial assessment (for specialists) is payable on the same day prior to the service. If the major pre-operative assessment is on the same day, no other assessment is payable prior to the service by the same physician. Manual review is not required for Z322 when rendered in association with gastroscopy, oesophagoscopy, oesophagoscopy-gastroscopy, duodenoscopy, and small bowel push enteroscopy services.
When to Use
- Use Z322 when performing a direct laryngoscopy specifically to remove a foreign body, distinguishing it from diagnostic procedures like Z292 or Z293.
- Use Z322 when the procedure is performed in conjunction with an upper GI endoscopy (e.g., gastroscopy), as it is explicitly exempt from manual review in these combinations.
Common Pitfalls
- Billing a full assessment (A-code) on the same day as Z322 is a common rejection; as an Independent Operative Procedure (IOP), only a minor or partial assessment is payable if the major pre-operative visit occurred within the last 12 months.
- Failing to apply the correct age-based premium (e.g., AGE_PREMIUM_UNDER_1_YEAR) results in underpayment, as these are mandatory add-ons for pediatric patients.
- Attempting to bill Z322 alongside other surgical procedures without applying the 15% reduction rule for secondary procedures performed during the same hospitalization.
Billing Tips
- Ensure the foreign body removal is clearly documented in the operative report to justify the use of Z322 over a standard diagnostic laryngoscopy code.
- When performing Z322 during an after-hours period, append the appropriate premium (E409 or E410) to the procedural fee to maximize reimbursement for non-elective cases.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
1. E600 is not eligible for payment in addition to E643.
2. Z292 rendered in association with gastroscopy, oesophagoscopy, oesophagoscopy-gastroscopy, duodenoscopy, and small bowel push enteroscopy services is not eligible for payment unless the laryngoscopy service is rendered for suspicion of disease of the larynx. Claims for Z292 in these circumstances are assessed by a medical consultant on a manual review basis and require the submission of a written explanation.
3. Z296 is not eligible for payment in addition to Z292 on the same patient on the same date of service.
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