Z578 – Multiple para-aortic lymph nodes
OHIP Psychiatric Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits
Biopsy of multiple para-aortic lymph nodes. This procedure is classified under the Haematic and Lymphatic Surgical Procedures section. Payment is made for the surgeon (suffix A), and may be eligible for an assistant (suffix B) and anaesthetist (suffix C) based on the rules outlined in the General Preamble.
When to Use
- Use Z578 when performing a formal surgical biopsy of multiple para-aortic lymph nodes, distinct from simple superficial node sampling like R910 or R912.
- Select Z578 for retroperitoneal lymph node exploration where multiple nodes are harvested, rather than solitary node excision codes like Z410 or Z413.
Common Pitfalls
- Billing Z578 in conjunction with abdominal exploration codes (e.g., S-codes) may trigger an 'incidental procedure' rejection if the biopsy is considered an integral part of a larger resection.
- Failing to document the specific anatomical location and the count of nodes harvested often leads to audit adjustments, as Z578 specifically requires 'multiple' nodes.
Billing Tips
- Ensure that if the procedure is performed as part of a trauma case meeting ISS criteria, you append E420 to capture the 50% premium, as Z578 is an eligible surgical procedure.
- Verify that the operative report explicitly details the para-aortic location to distinguish this from peripheral lymph node biopsies (R910-R916) which carry different fee structures.
Effective: April 1, 2025
R. Haematic and Lymphatic Surgical Procedures
HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES
Surgical
Haematic and Lymphatic Surgical Procedures
All insured services must be documented in appropriate records that establish the service was provided, is the service for which the account is submitted, and was medically necessary.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.