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Z478
Z478 – Vaginoscopy (premenarchal)
OHIP Psychiatric Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Vaginoscopy (Z478) is an endoscopic procedure performed on a premenarchal patient to examine the vagina. This procedure can be performed with or without medication. It is listed under the 'ENDOSCOPY' subsection for the Vagina in the 'Female Genital Surgical Procedures' section of the Schedule of Benefits.
When to Use
- Use Z478 for the diagnostic investigation of a premenarchal patient presenting with a suspected foreign body in the vagina.
- Use Z478 for the evaluation of persistent or recurrent vaginal discharge in a premenarchal patient where physical examination is inconclusive.
- Use Z478 when performing an endoscopic inspection to rule out congenital anomalies or structural abnormalities in the premenarchal vagina.
Common Pitfalls
- Billing Z478 for a patient who has reached menarche; this code is strictly restricted to premenarchal patients and will be rejected or audited if the patient's age/history contradicts this.
- Attempting to bill an additional office visit code (e.g., A007) on the same day as Z478; the surgical fee for Z478 is intended to be comprehensive for the procedure and the associated assessment.
- Confusing Z478 with Z552; Z478 is specific to the vagina, whereas Z552 applies to culdoscopy (peritoneal/abdominal cavity).
Billing Tips
- Always append the appropriate age-based premium (e.g., 10% to 30% depending on age) to the Z478 base fee to ensure you are capturing the full value of the service as permitted by the Schedule of Benefits.
- If the procedure is performed on an emergency basis after hours, ensure you select the correct non-elective premium (E409A or E410A) rather than a general after-hours code to maximize the claim accuracy.
Provider Fee$56.70
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
V. Female Genital Surgical Procedures
Subcategory
FEMALE GENITAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Female Genital Surgical Procedures
Sex Restriction
Female
Culdoscopy - see Z552 - Abdomen, Peritoneum and Omentum - Digestive System.
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