Z561 – Endoscopic retrograde cholangiopancreatography with cannulation of common bile duct and/or pancreatic duct
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Endoscopic Retrograde Cholangiopancreatography (ERCP) with cannulation of common bile duct and/or pancreatic duct is a surgical procedure listed under the Digestive System section. Several additional procedures may be performed and billed as add-ons, including biopsies (E702), biliary tract manometry (E666), intraductal cytology brushing or biopsy (E662), cannulation of the minor papilla (E668), insertion of prostheses or stents (E680, E681), and oesophagoscopy-gastroscopy (E669).
When to Use
- Use Z561 when performing a diagnostic or therapeutic ERCP that successfully achieves cannulation of the common bile duct or pancreatic duct.
- Select Z561 over Z558 when the primary intent and procedural success involve ductal cannulation rather than simple endoscopic evaluation or non-cannulated biliary intervention.
Common Pitfalls
- Billing Z561 in conjunction with E669 (oesophagoscopy-gastroscopy) is only permitted when the E669 is performed as a distinct, necessary component of the procedure, not as a routine part of the ERCP scope passage.
- Attempting to bill E816 without documented evidence of choledocholithiasis that failed standard extraction methods will result in a rejection or audit recovery.
Billing Tips
- Always append the appropriate add-on codes like E680 or E681 for stent placement to maximize the claim value, as these are specifically permitted alongside Z561.
- Ensure the operative report explicitly details the cannulation success to support the Z561 claim, especially if the procedure is complex or involves multiple ductal attempts.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
Unless otherwise specified, there is no additional fee payable for cholangiogram during abdominal surgery.
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