All codes
Z638
Z638 – Endoscopic treatment of vesicoureteral reflux by subureteral injection of agent
OHIP Psychiatric Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Endoscopic treatment of vesicoureteral reflux by subureteral injection of agent, unilateral or bilateral.
When to Use
- Use Z638 for the endoscopic subureteral injection of bulking agents (e.g., Deflux) to treat primary vesicoureteral reflux (VUR).
- This code is the appropriate choice for both unilateral and bilateral procedures, as the fee is inclusive regardless of the number of ureters injected.
Common Pitfalls
- Do not bill Z638 in conjunction with Z606, Z607, Z611, Z617, or Z628, as these are restricted billing combinations.
- Avoid attempting to bill this code as a 'bilateral' procedure; the fee is fixed and does not allow for additional billing for the second side.
Billing Tips
- Ensure you apply the appropriate age-based premium (e.g., AGE_PREMIUM_5Y_16Y) to the $450.00 base fee, as these are frequently applicable to pediatric VUR patients.
- If the procedure is performed on an emergency basis after hours, ensure the claim includes the correct after-hours premium (E409 or E410) to maximize the procedural reimbursement.
Provider Fee$450.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Since Oct 2009, this fee has increased 0.0% vs 42.6% 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
All insured services must be documented in the patient's medical record to establish that the service was provided, the service claimed is the service that was rendered, and the service was medically necessary. Refer to .
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.