Z333 – Mediastinoscopy with transbronchial biopsy under image intensification (including bronchoscopy)
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
A diagnostic endoscopic procedure involving mediastinoscopy combined with a transbronchial biopsy performed under image intensification. The service also includes a bronchoscopy as a component of the procedure. As a 'Z-code', this service is designated an Independent Operative Procedure (IOP) and is subject to the rules for IOPs as outlined in the Surgical Preamble on page .
When to Use
- Use Z333 when performing a mediastinoscopy with transbronchial biopsy under image intensification, which explicitly includes the required bronchoscopy component.
- Select Z333 instead of Z329 (mediastinoscopy without biopsy) when the procedure involves the collection of tissue samples under image guidance.
Common Pitfalls
- Do not bill a separate bronchoscopy code (e.g., Z347 or Z348) on the same day, as the bronchoscopy is considered a component of the Z333 procedure.
- Failing to recognize Z333 as an Independent Operative Procedure (IOP) can lead to incorrect application of multiple procedure rules; ensure you follow the Surgical Preamble SP4 guidelines for IOPs.
Billing Tips
- If performing a secondary procedure during the same session, ensure the major procedure is billed at 100% and the secondary procedure is reduced by 15% according to the multiple procedure rule.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
As a 'Z' code, this service is an Independent Operative Procedure (IOP). See Surgical Preamble page for payment rules related to IOPs.
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