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Billing code

Z497A — Confirmatory Colonoscopy - Sigmoid To Descending Colon

Confirmatory colonoscopy

Bill for colonoscopy after a positive FOBT or FIT, sigmoidoscopy, barium enema or CT result.

Watch for: Payable only when one of the listed positive tests led to it, and only one colonoscopy code per patient per day.

Code

Z497A

Description

Confirmatory Colonoscopy - Sigmoid To Descending Colon

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

Confirmatory colonoscopy after a positive FOBT/FIT, sigmoidoscopy, barium enema or CT. One colonoscopy base code per patient per day.

What it covers

Z497 is the colonoscopy for risk evaluation billed to confirm a positive screening or imaging result. The fee covers the scope from the sigmoid to the descending colon; further extent is billed with add-ons (S16, S18).

It is payable for a patient with a positive faecal occult blood test or faecal immunochemical test (FIT), sigmoidoscopy, barium enema, or CT abdomen/pelvis or CT colonography (S16).

Billing rules

• Only payable when one of the listed positive tests (FOBT/FIT, sigmoidoscopy, barium enema, CT abdomen/pelvis or CT colonography) led to the colonoscopy (S16).
• Only one of Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499 or Z555 is payable per patient per day (S17).
• Z580 flexible sigmoidoscopy isn't payable with Z497 for the same patient the same day (S15).
• Fulguration, if performed, is included (S19). No surgical assistant fee is payable (Asst nil) (S16).
• A later colonoscopy after a normal Z497, with no intervening signs or symptoms, is billed as Z493 at guideline intervals (S16).
• Anaesthesia other than local infiltration, topical anaesthesia or procedural sedation is claimed as E032C (4 basic units plus time units), which replaces the listed basic and time units; GP97 extra units are payable with E032C (GP100). Time units and GP97 extra units aren't payable with Z497C, and E003C isn't payable for anaesthesia for Z497 (S18).
• 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

• E740 (splenic flexure), E741 (hepatic flexure), E747 (cecum) and E705 (terminal ileum) for how far the scope was passed (S18).
• Z571, Z518, Z517 or Z516 for the largest polyp removed, with E720, E520, E519 or E518 for up to 2 more (S19).
• E797 for management of uncomplicated bleeding; at colonoscopy it is payable only with Z496 or Z497 (S18).
• A035 consultation (when it is the visit where the decision to scope is made) or A034 partial assessment (when the major pre-operative visit was in the previous 12 months) for a general surgeon (SP4, A107).
• E749 when the colonoscopy is done in a private office; not payable in a hospital or ICHSC (S18, S19).

Related codes: Z555, Z496, Z493, Z499, Z498, E740, E747, Z580

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Intestines (Except Rectum), Colonoscopy for Risk Evaluation, page S16; notes S17-S19; anaesthesia GP100.

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