Z586 – Hysteroscopy with lysis of intrauterine adhesions/synechiae requiring a minimum of 60 minutes of surgical time
OHIP Psychiatric Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
A hysteroscopic procedure involving the lysis of intrauterine adhesions or synechiae. This service is specifically for procedures that require a minimum of 60 minutes of surgical time. The medical record must document the start and end times to support the duration. If the surgical time is less than 60 minutes, the service must be claimed as Z585.
When to Use
- Use Z586 for complex hysteroscopic adhesiolysis where the surgical time, defined as the interval from the start of the procedure to the completion of the lysis, is 60 minutes or longer.
- Use this code when the severity of intrauterine synechiae (e.g., Asherman syndrome) necessitates extensive dissection that exceeds the time threshold for Z585.
Common Pitfalls
- Claiming Z586 for procedures lasting less than 60 minutes, which will result in a rejection or clawback; these must be billed as Z585.
- Failing to explicitly document the start and end times of the surgical procedure in the operative report, which is a mandatory requirement for audit compliance.
- Attempting to bill Z586 in conjunction with other hysteroscopic codes like Z582, Z583, or Z587 on the same day, which is strictly prohibited by the OHIP Schedule of Benefits.
Billing Tips
- Ensure the operative note clearly delineates the start and end times of the procedure to justify the 60-minute duration required for Z586.
- If the procedure is non-elective and meets the time criteria, consider adding the appropriate after-hours premium (E409A or E410A) to the base fee.
Effective: April 1, 2025
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
Surgical
Female Genital Surgical Procedures
Surgical time must be a minimum of 60 minutes.
The time when the service started and ended must be recorded in the patient's permanent medical record.
Female
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