Z326 – Change of tracheostomy tube
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Change of tracheostomy tube. As an Independent Operative Procedure (IOP), this service's fee includes associated pre-operative and post-operative care. As per the Surgical Preamble (:532), if the major pre-operative visit was rendered within 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. If the major pre-operative assessment is rendered on the same day as the IOP, no other consultation or assessment is eligible for payment if rendered prior to the IOP service by the same physician.
When to Use
- Use Z326 for a routine or urgent tracheostomy tube change performed as an Independent Operative Procedure (IOP).
- Use Z326 when the procedure is performed in a clinical setting where the physician is not already billing a comprehensive visit that includes the tube change as part of the global fee.
Common Pitfalls
- Billing a major assessment (A007/A003) on the same day as Z326 by the same physician will result in a rejection, as Z326 is an IOP and the assessment is considered pre-operative.
- Attempting to bill Z326 alongside a consultation code (A005/A008) for the same patient on the same day will trigger a rejection due to the restriction on concurrent assessment codes.
- Failing to account for the 12-month rule: if you performed a major assessment in the last year, you are restricted to billing only a minor (K013) or partial assessment on the day of the procedure.
Billing Tips
- If the procedure is performed after hours (e.g., 17:00-07:00) for non-elective reasons, ensure you append the appropriate E409 or E410 premium to maximize the claim value.
- Always verify the patient's age to ensure the correct age-based surgical premium (e.g., under 30 days or 30 days to 1 year) is applied, as these are significant percentage increases over the base $12.50 fee.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.