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Z540
Z540 – Intubation of small intestine
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z540 is a surgical procedure for the intubation of the small intestine. This procedure may be performed for therapeutic or diagnostic reasons. As per the note with or without fluoroscopy on :, the use of fluoroscopy is optional, and if it is rendered, it is considered a component of the main procedure and included in the fee. This service is eligible for age-based premiums for patients under 16 years of age as described in the General Preamble (:). It is also eligible for after-hours (:) and trauma (:) premiums under specific conditions.
When to Use
- Use Z540 for the therapeutic placement of a long intestinal tube (e.g., Cantor or Miller-Abbott tube) to manage small bowel obstruction.
- Use Z540 for diagnostic intubation of the small intestine when specific sampling or localization is required beyond standard endoscopic reach.
Common Pitfalls
- Do not bill separately for fluoroscopy; the Schedule of Benefits explicitly states that fluoroscopy is a component of Z540 and is included in the fee.
- Avoid billing Z540 in conjunction with after-hours premiums (E409/E410) and trauma premiums (E420) simultaneously, as these are mutually exclusive per the General Preamble.
- Ensure the biopsy add-on E732 is only claimed when a tissue sample is physically obtained; it is not a substitute for the base procedure fee.
Billing Tips
- Always append the appropriate age-based premium (e.g., AGE_PREMIUM_LT16Y) to Z540 if the patient is under 16, as this is a surgical procedure eligible for the General Preamble age-based increases.
- If performing a biopsy during the procedure, submit E732 on the same claim as Z540 to ensure the add-on is correctly processed.
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