Z865 – Probing and dilation of duct, initial or repeat - General anaesthetic - with insertion of inlying tube or filament
OHIP Psychiatric Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Probing and dilation of the nasolacrimal duct, performed as an initial or repeat procedure under general anaesthetic. This service is differentiated from Z864 by the specific inclusion of inserting an inlying tube or filament.
When to Use
- Use Z865 when performing nasolacrimal duct probing and dilation that specifically requires the placement of a silicone stent or lacrimal tube under general anaesthetic.
- Select Z865 instead of Z864 when the surgical plan explicitly includes the insertion of an inlying tube or filament to maintain duct patency post-procedure.
Common Pitfalls
- Billing Z865 when only simple probing or dilation is performed without the insertion of a tube or filament, which should be billed under Z864.
- Failing to ensure the anaesthesiologist has documented the ASA physical status classification, which is a mandatory requirement for all procedures involving general anaesthesia.
Billing Tips
- Ensure the operative report clearly details the insertion of the tube or filament to justify the higher complexity and code selection over Z864.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures, Anaesthesiologists' Services
All insured services must be documented in the medical record to establish that the service was provided, medically necessary, and matches the submitted claim.
When anaesthesia is administered, the anaesthesiologist must document the patient's Physical Status Classification (ASA level) in the medical record at the time of the pre-operative anaesthesia assessment.
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