Z328 – Mediastinoscopy with mediastinotomy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
A diagnostic endoscopic procedure of the mediastinum, which also includes a mediastinotomy. This procedure is an Independent Operative Procedure (IOP). As an IOP, if the major pre-operative visit was rendered in the previous 12 months, only a minor assessment (by a GP) or partial assessment (by a specialist) may be payable on the same day. No other consultation or assessment is payable on the same day as the IOP if the major pre-operative visit is also on that day. See for full details.
When to Use
- Use Z328 when performing a diagnostic mediastinoscopy that includes a mediastinotomy for tissue sampling or biopsy of mediastinal nodes.
- Use Z328 as the primary procedure code when the mediastinotomy is an integral component of the endoscopic approach to the mediastinum.
Common Pitfalls
- Billing a consultation or assessment on the same day as Z328 is a common rejection if a major pre-operative visit was already claimed within the previous 12 months.
- Attempting to bill Z328 alongside other respiratory surgical procedures without applying the 85% reduction rule for multiple procedures performed under the same anaesthesia.
- Failing to recognize Z328 as an Independent Operative Procedure (IOP), which restricts the ability to claim additional assessment codes on the day of the procedure.
Billing Tips
- If performing multiple procedures under the same anaesthesia, ensure the major procedure is billed at 100% and subsequent procedures are reduced to 85% to avoid automatic claim adjustments.
- Always verify if the patient meets the criteria for E409 or E410 premiums if the procedure is non-elective and performed outside standard hours to maximize the procedural fee.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
All insured services must be documented in appropriate records, establishing that the service was provided, medically necessary, and is the same service for which the account is submitted, as per .
For surgical procedures, the medical record should include details of supervising the preparation of the patient, performing the procedure, any related arrangements for assessments or therapy, and post-procedure follow-up care, as per .
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