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Z630
Z630 – Extracorporeal shock wave lithotripsy
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Extracorporeal shock wave lithotripsy (Z630) is a procedure listed under Extra Renal Procedures in the Urogenital and Urinary Surgical Procedures section of the Schedule. It involves the use of high-energy shock waves to break down stones in the kidney and upper urinary tract into smaller pieces that can pass out of the body through urination.
When to Use
- Use Z630 for the primary treatment of symptomatic nephrolithiasis or ureterolithiasis when performing extracorporeal shock wave lithotripsy (ESWL).
- Select Z630 when the procedure is performed as a standalone surgical intervention for stone fragmentation, distinct from endoscopic procedures like ureteroscopy (e.g., Z631).
Common Pitfalls
- Billing Z630 in conjunction with other surgical procedures on the same site during the same session often triggers a 'multiple procedure' reduction or rejection if not properly appended with the appropriate diagnostic code.
- Attempting to bill an office visit code on the same day as Z630 will result in a rejection, as the procedure fee is intended to be comprehensive of the surgical encounter.
Billing Tips
- Ensure the claim includes the specific location of the stone via the appropriate diagnostic code to justify the necessity of the ESWL procedure.
- If the procedure is performed on an emergency basis, verify if the patient meets the criteria for the E420 trauma premium, provided the ISS score is documented and the service occurs within 24 hours.
Provider Fee$320.65
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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