Z334 – Total unilateral lung lavage with or without bronchoscopy using Double Lumen Tube and single lung anaesthesia
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Total unilateral lung lavage is a surgical procedure for washing out an entire lung, which may be performed with or without the use of a bronchoscope. The procedure requires the use of a Double Lumen Tube to facilitate single-lung anaesthesia and ventilation. As a 'Z' code, this service is designated as an Independent Operative Procedure (IOP), which has specific rules regarding pre- and post-operative care billing. See for details on IOP billing.
When to Use
- Use Z334 for therapeutic whole-lung lavage in patients with pulmonary alveolar proteinosis requiring single-lung ventilation via a double-lumen tube.
- Use Z334 when performing a unilateral lung wash where the complexity of the procedure and the requirement for double-lumen tube placement distinguish it from standard diagnostic bronchoscopy codes like Z405.
Common Pitfalls
- Billing a consultation or major assessment on the same day as Z334 is prohibited because Z334 is an Independent Operative Procedure (IOP); only a partial assessment is permitted.
- Failing to recognize that pre- and post-operative care for multiple IOPs must be billed as if only one procedure occurred, even if the procedural fee for Z334 is claimed in full.
- Attempting to add on separate bronchoscopy codes when Z334 already explicitly includes the option for lavage with or without bronchoscopy.
Billing Tips
- Ensure you are not billing for the insertion of the double-lumen tube separately, as the requirements for single-lung anaesthesia are inherent to the Z334 procedure definition.
- If performing bilateral lavage in separate sessions, ensure the second procedure is billed correctly under the 14-day rule if within the same hospitalization, noting the 15% reduction for the lesser procedure if applicable.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures, Anaesthesiologists' Services
This is an Independent Operative Procedure (IOP).
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