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Z492
Z492 – Follow up of normal colonoscopy, absence of intervening signs or symptoms - sigmoid to descending
OHIP Digestive System Surgical Procedures Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Follow up of normal colonoscopy (Z499), absence of intervening signs or symptoms - sigmoid to descending. Z492 is an insured service when rendered at the frequency of follow up in accordance with current Ontario generally accepted clinical practice guidelines. It is eligible for payment for a colonoscopy rendered to a patient following a prior normal colonoscopy who has remained asymptomatic. A colonoscopy is considered normal if there were either no polyps or only small (<1 cm) hyperplastic polyps present. Effective July 1, 2026, colonoscopy services were changed to align with updated ColonCancerCheck recommendations (INFOBulletin 260702): screening for a family history associated with an increased risk of malignancy is repeated every 5 years beginning at age 40, or 10 years earlier than the youngest age a relative was diagnosed, with a 5 to 10 year follow-up interval. Claims system updates were completed in August 2026 (INFOBulletin 260801). Z580 is not eligible for payment with Z492 same patient same day; time units and anaesthesia extra units listed on are not eligible for payment with Z492C, and E003C is not payable for anaesthesia services rendered for Z492. Only one of Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 is eligible for payment per patient per day.
When to Use
- This code is for patients who are asymptomatic and having a follow-up after a previously normal colonoscopy.
Common Pitfalls
- Patients with serrated polyposis syndrome are excluded from this code and should be billed under Z494 instead.
- You cannot claim Z580 on the same day as this service for the same patient.
- Only a single code from the specified list of colonoscopy procedures is allowed per patient per day.
Billing Tips
- This code is only insured if the frequency of the follow-up adheres to current Ontario guidelines.
Usage limits
Payable at the follow-up frequency in current Ontario guidelines (5 to 10 year interval per INFOBulletin 260702).
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