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Z558
Z558 – Endoscopic retrograde cholangiopancreatography including sphincterotomy and removal of bile duct stones
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Endoscopic retrograde cholangiopancreatography (ERCP) including sphincterotomy and may include removal of one or more bile duct stones. This procedure is listed in the Digestive System surgical procedures section of the Schedule.
When to Use
- Use Z558 when performing a therapeutic ERCP that specifically includes a sphincterotomy and the successful removal of bile duct stones.
- Use Z558 instead of Z561 (diagnostic ERCP) when the procedure progresses beyond imaging to active therapeutic intervention involving sphincterotomy and stone extraction.
Common Pitfalls
- Billing Z558 and Z561 together for the same patient on the same day is a common rejection; Z558 is the comprehensive code for therapeutic ERCP and supersedes the diagnostic code.
- Failing to document the specific count of stents or biopsies when claiming add-on codes like E681 or E702, which can lead to recovery during an audit.
- Attempting to claim E816 without explicit documentation that the choledocholithiasis was refractory to standard extraction methods, as this is a strict requirement for the add-on.
Billing Tips
- Always maximize your claim by appending relevant add-ons like E680 for the first stent and E681 for subsequent stents, ensuring you do not exceed the maximum of 3 units for E681.
- If an oesophagoscopy-gastroscopy is performed during the same session, ensure E669 is included on the claim to capture the additional $102.75 fee.
Provider Fee$300.25
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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