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Z505
Z505 – Cricopharyngeal myotomy
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Cricopharyngeal myotomy performed either via endoscopy or in conjunction with another surgical procedure during the same anaesthetic. As per note on , this procedure is not eligible for payment with S086 (Cricopharyngeal myotomy, open approach).
When to Use
- Use Z505 when performing a cricopharyngeal myotomy via endoscopic approach, as it is distinct from the open surgical approach defined by S086.
- Use Z505 when the myotomy is performed as an adjunct procedure during a larger, primary surgical intervention under the same anaesthetic.
Common Pitfalls
- Billing Z505 in conjunction with S086 will result in an automatic rejection, as the Schedule of Benefits explicitly prohibits concurrent payment for these two codes.
- Attempting to bill Z505 as a standalone major procedure when the clinical documentation does not support the endoscopic approach will trigger audit scrutiny regarding the necessity of the chosen technique.
Billing Tips
- Ensure the operative report clearly specifies the endoscopic technique to justify the use of Z505 over the open approach S086, especially if the procedure is performed in a hospital setting.
Provider Fee$37.20
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
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