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Z518
Z518 – Excision of first polyp (6 mm to 9 mm)
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of the first polyp measuring between 6mm and 9mm, performed through a colonoscope. Per , if multiple polyps of different sizes are excised, the fee code for the largest polyp should be claimed as the 'first' polyp (e.g., Z516, Z517, Z518, or Z571). Excision of polyps smaller than 3mm is not an eligible service.
When to Use
- Use Z518 as the primary code when the largest polyp removed during the colonoscopy measures between 6mm and 9mm.
- Use Z518 when you have removed multiple polyps of varying sizes, provided the largest one falls within the 6mm to 9mm range.
Common Pitfalls
- Claiming Z518 alongside Z516, Z517, or Z571; only one primary polyp excision code is permitted per patient per day.
- Attempting to bill for the excision of polyps smaller than 3mm, which are considered non-eligible services under OHIP.
- Exceeding the maximum of two additional polyp add-on services (E720, E520, E519, or E518) per patient per day.
Billing Tips
- Always identify the largest polyp excised to determine the primary code (Z571, Z518, Z517, or Z516) before adding any eligible secondary excision codes.
- Ensure that any additional polyps (3mm to 29mm) are claimed using the appropriate flat-fee add-on codes (E720, E520, E519, or E518) to maximize the procedural claim.
Provider Fee$150.15
Anaesthetist Fee$61.96
Non-Anaesthetist Fee$61.96
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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