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Z348
Z348 – Mediastinoscopy - with bronchoscopy and mediastinotomy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This service, listed as Z348, is for a mediastinoscopy combined with a bronchoscopy and mediastinotomy. As a 'Z' code, it is classified as an Independent Operative Procedure (IOP). The rules for IOPs, as detailed on page of the Surgical Preamble, apply. This includes restrictions on billing for other assessments on the same day as the procedure. The surgical fee includes standard pre-operative and post-operative care as outlined in the Surgical Preamble on page .
When to Use
- Use Z348 when performing a comprehensive diagnostic workup involving both mediastinoscopy and bronchoscopy, often for staging lung cancer or evaluating mediastinal lymphadenopathy.
- Select this code when the procedure involves both the endoscopic visualization of the airways and the surgical exploration of the mediastinum through a mediastinotomy in a single operative session.
Common Pitfalls
- Billing Z348 alongside a separate bronchoscopy code (e.g., Z329) is a common error; Z348 is an all-inclusive procedural code that already accounts for the bronchoscopy component.
- Attempting to bill an assessment or consultation code on the same day as Z348 will result in automatic rejection, as Z348 is an Independent Operative Procedure (IOP) subject to the restrictions in the Surgical Preamble.
- Failure to apply the 15% reduction rule when performing a second, lesser elective procedure for a different condition during the same hospitalization by the same surgeon.
Billing Tips
- Ensure the operative report clearly documents both the mediastinotomy and the bronchoscopy components to justify the use of this specific code over individual respiratory procedure codes.
- If the procedure is non-elective and performed after hours, ensure the appropriate premium (E409 or E410) is appended to the claim to maximize the procedural fee.
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