Z547 – Gastroscopy - with removal of foreign body
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A gastroscopy procedure that includes the removal of a foreign body. This is an endoscopic procedure of the stomach. This service has 4 basic anaesthesia units. Add-on codes E674 (for the first polyp > 1 cm) and E675 (for each additional polyp > 1 cm, maximum 2) are payable with Z547 for snare polypectomy. As per the note on page , laryngoscopy (Z292) rendered in association with gastroscopy services is not eligible for payment unless it is for suspicion of laryngeal disease and requires manual review with a written explanation.
When to Use
- Use Z547 specifically when a foreign body is identified and successfully retrieved during a gastroscopy procedure.
- Use Z547 instead of Z527 (diagnostic gastroscopy) when the primary intent or outcome of the procedure involves the physical removal of an ingested or impacted foreign object.
Common Pitfalls
- Billing Z292 (laryngoscopy) alongside Z547 will trigger an automatic rejection, as it is restricted unless submitted with a written explanation for suspected laryngeal disease.
- Attempting to bill E674 or E675 for foreign body removal is incorrect; these add-on codes are strictly reserved for snare polypectomy of polyps greater than 1 cm.
Billing Tips
- Ensure the operative report clearly details the nature of the foreign body and the technique used for removal to support the Z547 claim in the event of an audit.
- If the procedure is performed on an emergency basis during night hours, apply the E410 premium to the Z547 fee to capture the 75% increase for non-elective services.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures, Diagnostic and Therapeutic Procedures
Z292 rendered in association with gastroscopy services is not eligible for payment unless the laryngoscopy service is rendered for suspicion of disease of the larynx. Claims for Z292 in these circumstances are assessed by a medical consultant on a manual review basis and require the submission of a written explanation.
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