Z584 – Small bowel push enteroscopy
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z584 is an endoscopic procedure used to investigate and treat conditions within the upper part of the small intestine, specifically the duodenum and jejunum, which may be beyond the reach of a standard gastroduodenoscope.
When to Use
- Use Z584 when the clinical objective is to visualize the jejunum beyond the reach of a standard gastroscope, distinguishing it from a standard diagnostic gastroscopy (Z560).
- Select Z584 for procedures involving therapeutic interventions in the proximal small bowel that require the specialized length and maneuverability of a push enteroscope.
Common Pitfalls
- Billing Z292 alongside Z584 without a specific, documented suspicion of laryngeal disease will result in automatic rejection and requires a manual review submission.
- Failing to recognize that Z584 is a distinct surgical procedure code; billing it as a standard gastroscopy (Z560) results in significant underpayment.
Billing Tips
- Ensure that the anaesthesia claim (Z584C) includes the appropriate basic units determined by comparison to similar endoscopic procedures, as no specific units are assigned in the Schedule.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
Z292 rendered in association with duodenoscopy and small bowel push enteroscopy 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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