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Z626
Z626 – Nephroscopy
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Nephroscopy, percutaneous or retrograde, is a surgical procedure for visually examining the interior of the kidney. The procedure is performed using a nephroscope, which is inserted either through a small incision in the skin (percutaneously) or by advancing it from the bladder up the ureter to the kidney (retrograde).
When to Use
- Use Z626 for diagnostic visualization of the renal pelvis and calyces via a nephroscope when no therapeutic intervention, such as stone extraction or biopsy, is performed.
- Select this code for retrograde nephroscopy performed during a cystoscopy session where the primary intent is visual inspection of the upper urinary tract.
Common Pitfalls
- Do not bill Z626 in conjunction with therapeutic procedures like lithotripsy or stone removal, as these are typically covered by more comprehensive surgical codes.
- Avoid billing Z626 as a standalone procedure if it is performed as a mandatory component of a more extensive renal surgery, as it is considered bundled into the primary procedure fee.
- Failure to recognize that Z626 does not have pre-assigned assistant units; billing an assistant without M400B and a supporting letter of explanation will result in automatic rejection.
Billing Tips
- If surgical assistance is medically necessary for a complex nephroscopy, submit M400B with a detailed letter of explanation referencing the 6 units listed in the anaesthesia column to justify the assistant's fee.
Provider Fee$102.85
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
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