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Z330
Z330 – Mediastinoscopy with bronchoscopy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Mediastinoscopy with bronchoscopy is an endoscopic surgical procedure performed on the chest wall and mediastinum. This service is an Independent Operative Procedure (IOP), indicated by the 'Z' prefix, and includes standard pre-operative and post-operative care as defined in the Surgical Preamble. For details on what is included in a surgical service, see .
When to Use
- Use Z330 when performing a diagnostic mediastinoscopy combined with a bronchoscopy during the same operative session for staging lung cancer or evaluating mediastinal lymphadenopathy.
- Use this code when the clinical requirement necessitates both the visualization of the tracheobronchial tree and the surgical exploration of the mediastinum.
Common Pitfalls
- Billing Z330 alongside separate bronchoscopy codes (e.g., Z329) is a common error; Z330 is an all-inclusive IOP that covers the combined procedure.
- Failing to account for the multiple procedure rule (85% reduction) when performing additional unrelated surgical procedures during the same anesthesia session.
- Attempting to bill a separate pre-operative assessment on the same day as the Z330, which is restricted under the Surgical Preamble for IOPs.
Billing Tips
- Ensure the operative report clearly details both the bronchoscopic findings and the mediastinal exploration to justify the use of this combined code over individual components.
- If performing a biopsy during the procedure, do not bill for the biopsy separately as it is considered an integral component of the surgical service.
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