< Billing codes

Billing code

E677A

Lymph node needle aspiration

Add to Z327 bronchoscopy for transbronchial needle aspiration of mediastinal or hilar lymph nodes.

Watch for: Must be billed with a paid Z327; EBUS-guided node biopsy is G050 instead.

Code

E677A

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 needle aspiration (TBNA) of mediastinal and/or hilar lymph nodes.

What it covers

E677 is bronchoscopy with transbronchial needle aspiration (TBNA) of mediastinal and/or hilar lymph nodes (P9).

EBUS-guided biopsy of hilar and/or mediastinal nodes is a separate code, G050, with E837 for additional biopsies (P10).

Billing rules

• Add-on only: bill E677 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, E678, G050, E837, E638

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

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