Z738 – Insertion of Montgomery “T” Tube or similar laryngeal or tracheal stent
OHIP Psychiatric Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Insertion of Montgomery “T” Tube or similar laryngeal or tracheal stent. This is an Independent Operative Procedure (IOP) as designated by the 'Z' prefix. As per , if the major pre-operative visit was rendered in the previous 12-month period by the same physician, only a minor assessment (by a General/Family Physician) or a partial assessment (by a specialist) is payable on the same day prior to the IOP service. The surgical fee includes pre-operative and post-operative care as outlined in the Surgical Preamble. The anaesthesia benefit is calculated based on 8 basic units plus time units. The assistant benefit is calculated based on 6 basic units plus time units.
When to Use
- Use Z738 for the primary placement of a Montgomery T-tube to maintain airway patency in patients with tracheal stenosis or malacia.
- Use Z738 for the insertion of similar laryngeal or tracheal stents when the procedure is performed as an Independent Operative Procedure (IOP).
Common Pitfalls
- Billing a full consultation or major assessment on the same day as Z738 is prohibited if a major pre-operative visit occurred within the previous 12 months; only a minor or partial assessment is permitted.
- Attempting to bill a second assistant for Z738 without prior authorization from a medical consultant will result in rejection, as it is not on the pre-approved list for two assistants.
- Failing to document the specific BMI in the medical record when attempting to claim E676A or E676B for morbidly obese patients will lead to audit recovery.
Billing Tips
- Ensure the procedure is coded as an IOP; if performing multiple procedures, remember that the 85% rule applies to the lesser procedure unless it is a non-elective procedure for a new condition.
- Maximize revenue by applying the appropriate After Hours Procedure Premium (E409 or E410) if the procedure meets the non-elective criteria and time-of-day requirements.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
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