Z618 – Urethral endoscopy with biopsy
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This procedure involves the endoscopic examination of the urethra (urethroscopy) combined with the removal of a small piece of tissue (biopsy) for pathological analysis. This service is performed by a surgeon and may require anaesthesia.
When to Use
- Use Z618 when performing a diagnostic urethroscopy specifically to obtain a tissue specimen for pathology, distinguishing it from a simple diagnostic urethroscopy billed under Z617.
- Apply Z618 when a biopsy is taken during a urethral procedure that does not involve the bladder, as bladder biopsies are billed under separate cystoscopy codes like S547.
Common Pitfalls
- Billing Z618 in conjunction with Z617 is considered unbundling, as the endoscopy is inherent to the biopsy procedure.
- Submitting Z618 for a procedure that is actually a bladder biopsy will lead to rejections or audit flags, as Z618 is strictly for urethral pathology.
Billing Tips
- If an assistant is medically necessary for this procedure, you must submit M400B with a formal letter of explanation to the Ministry to override the standard exclusion of assistance fees.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
Assistance at surgery is not listed as eligible for this procedure. Payment for an assistant may be considered by a medical consultant upon individual consideration by submitting fee code M400B with a letter of explanation from the surgeon. See for details.
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