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Billing code

E740A — Colonoscopy to splenic flexure (add-on)

Colonoscopy to splenic flexure

Add to a colonoscopy when the scope is passed to the splenic flexure.

Watch for: Only with Z491 to Z499 or Z555, one extent add-on per colonoscopy, and not with Z580 the same day.

Code

E740A

Description

Colonoscopy to splenic flexure (add-on)

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

Colonoscopy add-on when the scope reaches the splenic flexure, billed with the colonoscopy code (Z491–Z499 or Z555).

What it covers

E740 is an add-on to a colonoscopy when the scope is passed to the splenic flexure (S18).

The colonoscopy base codes (Z491–Z499, Z555) are each defined as 'sigmoid to descending colon' and differ by indication: screening, follow-up, symptoms, high risk and so on (S16–S17).

Billing rules

• Payable only with Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 (S18).
• No surgical assistant fee is payable (Asst nil) (S18).
• Only one of Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 is payable per patient per day (S17).
• Z580 flexible sigmoidoscopy is not payable with any of these colonoscopy codes for the same patient the same day (S15).
• Marked '#': the fee doesn't include premises, equipment, supplies or staff, which are funded by the hospital budget or ICHSC facility costs; patients can't be charged for them (GP13).

Often billed with

• The colonoscopy base code for the indication, for example Z555 (no symptoms or risk factors, 50+) or Z496 (signs or symptoms) (S16–S17).
• E749 when the colonoscopy is done in a private office, not in a hospital or ICHSC (S18–S19).
• Polypectomy codes Z571, Z518, Z517 or Z516 for the largest polyp, with E720, E520, E519 or E518 for up to 2 more (S19).
• E717 biopsy or coagulation of angiodysplastic lesions, or E785 IBD surveillance biopsies, but not both (S18).

Common rejections

• A3H: More services were billed on the line than OHIP allows; an extent add-on is one service per colonoscopy (A3H guide).
• VJ7: The claim reached OHIP more than three months after the service date; resubmit as stale-dated only if it was first sent on time (VJ7 guide; GP9).
• ERF: The referring physician on the claim isn't currently eligible to refer, per OHIP's records; check the referring provider number before resubmitting.

Related codes: Z555, Z496, Z497, Z499, E741, E747, E705, E749

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Intestines (Except Rectum), Colonoscopy, page S18; base codes S16–S17.

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