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Z628

Z628 – Cystoscopy and diagnostic Ureteroscopy - above intramural

OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits

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A surgical procedure for diagnostic ureteroscopy performed above the intramural portion of the ureter. This is a surgical procedure payable to the surgeon (suffix A) and includes anaesthesia services (suffix C). The anaesthesia fee is calculated using 6 base units plus time units as described on page . This service can be enhanced with several add-on procedures, including: - E819: diagnostic ureteroscopy of second ureter - E822: ureteroscopy to upper third of ureter or renal pelvis - E760: with removal of calculus - E761: intracorporeal lithotripsy by any method - E820: with biopsy of one or more sites - E823: resection and fulgarization of tumours Note: Z628 is not eligible for payment with Z638.

When to Use

  • Use Z628 when performing a diagnostic ureteroscopy that extends beyond the intramural portion of the ureter into the mid or upper ureter.
  • Use Z628 as the primary base code when performing ureteroscopy to facilitate add-on procedures like E760 for calculus removal or E820 for biopsy.

Common Pitfalls

  • Billing Z628 in combination with Z638 will result in a rejection, as these are mutually exclusive codes.
  • Attempting to bill Z628 for procedures that do not reach beyond the intramural ureter; ensure the scope placement meets the 'above intramural' criteria.

Billing Tips

  • Always append the appropriate add-on codes (e.g., E822, E760, E761) to Z628 to capture the full scope of the surgical intervention performed during the same session.
  • Ensure anaesthesia services are billed using the 6 base units plus time units as specified in GP93, as these are included in the surgical fee structure for Z628.
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Provider Fee$125.70
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

Since Oct 2005, this fee has increased 0.0% vs 51.4% CPI inflation
Category

T. Urogenital and Urinary Surgical Procedures

Subcategory

UROGENITAL AND URINARY SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Urogenital and Urinary Surgical Procedures

Z638E819E822E760E761E820E823Z606Z607Z611Z617

Z606, Z607, Z611, Z617 and Z628 are not eligible for payment with Z638.

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Z628 – Cystoscopy and diagnostic Ureteroscopy - above intramural | OHIP Fee Schedule | SnapBill MD