Billing code
Z493A — Follow Up Of Normal Colonoscopy (z497, Z555), Absence Of Intervening Signs Or Symptoms Sigmoid To Descending
Follow-up after normal screening colonoscopy
Bill for a follow-up colonoscopy after a normal Z497 or Z555 colonoscopy, when the patient has had no symptoms since.
Watch for: Insured only at the follow-up interval in current Ontario guidelines, and only one colonoscopy code per patient per day.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $51.95 | $0.00 | $0.00 | $79.80 | $79.80 |
- Code
- Z493A
- Description
- Follow Up Of Normal Colonoscopy (z497, Z555), Absence Of Intervening Signs Or Symptoms Sigmoid To Descending
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Follow-up colonoscopy after a normal Z497 or Z555 colonoscopy, when the patient has had no symptoms since.
What it covers
Z493 is a follow-up of a normal colonoscopy billed as Z497 (confirmatory, after a positive test) or Z555 (average-risk screening), in a patient with no intervening signs or symptoms (S16).
A colonoscopy is normal if there were no polyps, or only small (under 1 cm) hyperplastic polyps (S16).
Billing rules
- Insured only at the follow-up frequency in current Ontario generally accepted clinical practice guidelines (S16).
- Only for a patient whose prior colonoscopy was normal and who has stayed free of symptoms (S16).
- Only one of Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 is payable per patient per day, and sigmoidoscopy Z580 is not payable with it the same day (S15, S17).
- The fee covers sigmoid to descending colon; add E740 (splenic flexure), E741 (hepatic flexure), E747 (cecum) or E705 (terminal ileum) for the extent reached. Fulguration is included (S18, S19).
- Add E749 when done in a private office; not payable in a hospital or ICHSC (S18, S19).
- Anaesthesia is billed as E032C (4 basic units plus time units); E003C is not payable, and GP97 time and extra units aren't payable on the colonoscopy C-suffix code (GP100, S18).
- Colonoscopy for chronic constipation is only insured for patients 50 or older, with a family history of increased cancer risk, or with alarm features (S18).
- Same-day assessment by Internal Medicine or Gastroenterology: see A120 (A104, S19). A pre-colonoscopy consultation is only payable if the chart shows it was medically necessary (GP18).
Often billed with
- E740, E741, E747 or E705 for extent beyond the descending colon (S18).
- Polypectomy Z571, Z518, Z517 or Z516 by size of the largest polyp, plus E720, E520, E519 or E518 for up to 2 more polyps per day; polyps under 3 mm aren't payable (S19).
- E749 when done in a private office (S18).
- E785 for IBD surveillance biopsies with diagnostic code 555, 556 or 576 and the required technique (S18, S19).
Related codes: Z497, Z555, Z492, Z496, E747, E749, A120
Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Intestines (Except Rectum), Colonoscopy, page S16.
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing