Z338 – Lobectomy, segmentectomy or wedge resection, by thoracotomy or thoracoscopy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This service is for a biopsy of the pleura or lung performed with a limited thoracotomy. As a 'Z' code, this is an Independent Operative Procedure (IOP). - Anaesthesia: 13 base units. See the Anaesthesiologists' Services section starting on page for calculation of time units and total fee. - Assistant: 9 base units. See the Surgical Assistants' Services section starting on page for calculation of time units and total fee. Payment for all surgical procedures includes payment for any intra-operative monitoring of the patient, if rendered.
When to Use
- Use Z338 for a wedge resection or segmentectomy performed via thoracoscopy or limited thoracotomy when the primary intent is a diagnostic biopsy of the lung or pleura.
- Select Z338 when the procedure is an Independent Operative Procedure (IOP) and does not form part of a more extensive pulmonary resection that would be billed under a different M-code.
Common Pitfalls
- Billing a consultation or assessment on the same day as Z338 is a common rejection; as an IOP, only a minor or partial assessment is permitted if the major pre-operative visit occurred within the previous 12 months.
- Attempting to bill Z338 alongside other surgical procedures without applying the 85% multiple procedure rule (SP3) will lead to automatic payment adjustments or audit flags.
- Claiming the hospital admission assessment as a separate fee is prohibited; this is considered included in the surgical fee unless it represents the specific decision-making visit where the surgery was scheduled.
Billing Tips
- Ensure the operative report clearly details the extent of the resection (wedge vs. segmentectomy) to justify the use of Z338 over less invasive diagnostic codes.
- If performing this procedure on a pediatric patient, always verify the age-based premium eligibility (under 16 years) to maximize the claim value for both the surgeon and assistant.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
This service is an Independent Operative Procedure (IOP).
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