Z355 – Quadroscopy or panendoscopy
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Quadroscopy or panendoscopy, using separate instruments in search of malignant disease. This service includes: - Nasopharyngoscopy - Laryngoscopy - Bronchoscopy - Oesophagoscopy - with or without biopsy - with or without gastro-duodenoscopy This service is designated as an Independent Operative Procedure (IOP). See for specific rules regarding billing pre-operative assessments on the same day.
When to Use
- Use Z355 when performing a comprehensive panendoscopy (nasopharyngoscopy, laryngoscopy, bronchoscopy, and oesophagoscopy) specifically to investigate suspected malignancy.
- Use Z355 as the primary code when multiple endoscopic procedures are performed during the same operative session for cancer screening or staging, as it encompasses the individual components.
- Use Z355 instead of billing individual components (e.g., separate bronchoscopy or laryngoscopy codes) to avoid unbundling, as Z355 is designed to capture the entire panendoscopy procedure.
Common Pitfalls
- Billing a consultation or assessment on the same day as Z355 is a common rejection; as an IOP, pre-operative assessments are restricted by SP4 rules.
- Attempting to bill individual endoscopic components (e.g., separate laryngoscopy or bronchoscopy codes) alongside Z355 will result in payment rejection for unbundling.
- Failing to secure prior authorization from a medical consultant when billing for a surgical assistant via M400B, which is required because Z355 does not have pre-listed assistant units.
Billing Tips
- When claiming for a surgical assistant, use M400B and explicitly cite 6 basic units, matching the anaesthesia basic units for Z355, and include the required surgeon's letter of justification.
- Ensure the operative report clearly documents the findings for each component (nasopharyngoscopy, laryngoscopy, bronchoscopy, and oesophagoscopy) to justify the use of the panendoscopy code over individual procedure codes.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
This procedure is an Independent Operative Procedure (IOP) as indicated by the 'Z' prefix. Specific rules apply to billing pre-operative assessments. See .
Assistance at surgery: While no assistant units are listed, assistance may be claimed using M400B on an independent consideration basis with medical consultant authorization. The basic units would be 6, the same as for anaesthesia. See .
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