Z785 – Excision and suture of rectal or sigmoid polyp or tumour - base over 5 cm
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision and suture of a polyp or tumour of the rectum or sigmoid, where the base of the lesion is over 5 cm. Note: - This procedure is limited to a maximum of 2, for any size or technique. () - For fulguration or excision of tumours through the colonoscope, refer to procedures on page .
When to Use
- Use Z785 for the open surgical excision and suture of a rectal or sigmoid lesion where the base diameter exceeds 5 cm.
- Use this code when the procedure is performed via an open approach, as endoscopic excisions are specifically excluded and must be billed under the S19 section codes.
Common Pitfalls
- Billing Z785 for endoscopic procedures; endoscopic polyp or tumour excisions must be billed using the appropriate colonoscopy codes found on page S19.
- Exceeding the maximum limit of 2 procedures per patient, as Z785 is strictly capped at a maximum of 2, regardless of the technique or size of the lesion.
- Failing to document the base size of the lesion, which is a mandatory requirement to justify the use of Z785 over smaller excision codes like Z784.
Billing Tips
- If laser debulking is performed in conjunction with the excision, ensure you append the E688 add-on code to the claim to capture the additional fee.
- Verify that the procedure is not being billed alongside a standard hospital admission assessment, as these are ineligible unless it qualifies as the major pre-operative visit.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
All insured services must be documented in the patient's medical record, establishing that the service was provided, medically necessary, and is the service for which the account is submitted. ()
To a maximum of 2, any size or technique.
For fulguration or excision of tumours through the colonoscope, refer to page .
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