Z752 – Biopsy of rectosigmoid or above for Hirschsprung’s disease
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision of tissue from the rectosigmoid or a higher region for the purpose of diagnosing Hirschsprung's disease. This service is eligible for surgeon (<suffix>A</suffix>), assistant (<suffix>B</suffix>), and anaesthetist (<suffix>C</suffix>) services.
- The surgeon's fee (<suffix>A</suffix>) is a flat rate.
- The assistant's fee (<suffix>B</suffix>) is calculated based on 6 base units plus time units as per .
- The anaesthetist's fee (<suffix>C</suffix>) is calculated based on 6 base units plus time units as per .
When to Use
- Use Z752 for a full-thickness rectal biopsy specifically indicated for the diagnosis of Hirschsprung's disease, distinguishing it from general mucosal biopsies.
- Use Z752 when performing the primary diagnostic biopsy procedure in the rectosigmoid region, ensuring the diagnosis of Hirschsprung's is the clinical focus.
Common Pitfalls
- Failing to bill E710 for additional biopsy sites when multiple tissue samples are taken, as Z752 covers only the initial procedure.
- Attempting to bill a separate hospital admission assessment when the patient was already seen by the surgeon for the decision to operate, which is restricted by OHIP's 'major pre-operative visit' rules.
Billing Tips
- Always apply the appropriate age-based premium (e.g., 30% for patients under 30 days) as Z752 is a surgical procedure and these premiums are mandatory for qualifying pediatric patients.
- Ensure the clinical record explicitly documents the suspicion of Hirschsprung's disease to support the use of Z752 over generic biopsy codes.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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