All codes
Z616
Z616 – Biopsy of urethra (without endoscopy)
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for obtaining a tissue sample from the urethra for diagnostic purposes. This procedure is performed without the aid of an endoscope. The fee includes the common and specific elements applicable to surgical procedures as outlined in the Schedule of Benefits on pages to .
When to Use
- Use Z616 for a manual punch or excisional biopsy of a palpable urethral lesion performed in an office or clinical setting without the use of a cystoscope.
- Use Z616 when obtaining a tissue sample from the external urethral meatus or distal urethra where direct visualization is possible without endoscopic equipment.
Common Pitfalls
- Billing Z616 in conjunction with any endoscopic procedure code (e.g., Z617) is a common error, as Z616 is specifically for non-endoscopic biopsies.
- Attempting to bill Z616 for a routine urethral swab or culture is incorrect; this code is strictly for surgical tissue biopsy.
- Failure to document the specific anatomical site and the method of biopsy can lead to audit rejections if the claim is flagged for clinical necessity.
Billing Tips
- Ensure you are not billing a separate office visit fee (e.g., A007) on the same day unless the biopsy was an incidental finding during a visit for an unrelated condition, as the surgical fee generally covers the assessment for the procedure.
Provider Fee$25.25
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
Effective: April 1, 2026
Category
T. Urogenital and Urinary Surgical Procedures
Subcategory
UROGENITAL AND URINARY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Urogenital and Urinary Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.