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Z493
Z493 – Follow up of normal colonoscopy - sigmoid to descending
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Ten year follow up of normal colonoscopy (Z497, Z555), absence of intervening signs or symptoms - sigmoid to descending. This procedure is an endoscopic examination of the sigmoid and descending colon for patients who had a normal colonoscopy 10 years prior and have remained asymptomatic. A colonoscopy is defined as 'normal' for this purpose if it showed no polyps or only small (<1 cm) hyperplastic polyps.
When to Use
- Use for a 10-year surveillance sigmoidoscopy in an asymptomatic patient whose prior colonoscopy (Z497 or Z555) was normal or showed only small (<1 cm) hyperplastic polyps.
- Use when the clinical intent is a limited endoscopic examination specifically covering the sigmoid to descending colon for routine screening follow-up.
Common Pitfalls
- Billing Z493 for patients who had adenomatous polyps on their previous exam; these patients require different surveillance intervals and codes like Z491.
- Attempting to bill Z493 before the 10-year mark has elapsed, which renders the service uninsured and subject to rejection.
- Incorrectly using Z493 for symptomatic patients; this code is strictly for asymptomatic surveillance, and symptomatic patients require diagnostic codes.
Billing Tips
- Ensure the patient's history clearly documents the findings of the prior Z497 or Z555 to justify the 10-year interval and avoid audit recovery.
- If anesthesia is required, use E032C specifically, as it provides 4 basic units plus time, which is the mandatory replacement for the standard units associated with Z493C.
Provider Fee$51.95
Anaesthetist Fee$77.45
Non-Anaesthetist Fee$77.45
Effective: April 1, 2025
Since Apr 2013, this fee has increased 0.0% vs 33.2% CPI inflation
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
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