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Billing code

E638A

Transbronchial lung biopsy add-on

Add to Z327 bronchoscopy for a transbronchial lung biopsy, with or without fluoroscopy.

Watch for: Must be billed with a paid Z327; a simple bronchial biopsy is already included in Z327.

Code

E638A

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Add-on to bronchoscopy (Z327) for transbronchial lung biopsy, with or without image intensification.

What it covers

E638 is bronchoscopy with transbronchial lung biopsy, with or without image intensification (fluoroscopy) (P9).

A simple bronchial biopsy is already included in Z327 (P9).

Billing rules

• Add-on only: bill E638 with Z327 bronchoscopy (P9–P10).
• Bronchoscopy limits apply: only the bronchoscopy is paid with laryngoscopy or oesophagoscopy, and none after thoracic surgery under the same anaesthetic by the same surgeon (P9).
• Marked '#': premises, equipment, supplies and staff are not included in the fee (GP13).

Often billed with

• Z327 bronchoscopy, the base procedure (P9).

Common rejections

• ADF: OHIP's message is 'Corresponding Procedure Invalid, Omitted or Paid at zero': this add-on needs Z327 bronchoscopy on the same claim, paid (P9–P10).

Related codes: Z327, E636, E677, E678, Z340

Source: Schedule of Benefits (July 1, 2026), Respiratory Surgical Procedures, Trachea and Bronchi, page P9.

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