< Billing codes

Billing code

Z515A — Oesophagoscopy, With Or Without Biopsy(ies)

Oesophagus endoscopy

Bill for endoscopy of the oesophagus, with or without biopsies; biopsies are included in the fee.

Watch for: Not billed with an oesophageal stent S083, and pays zero with endoscopic ultrasound S236 or S237 unless visualization was limited.

Code

Z515A

Description

Oesophagoscopy, With Or Without Biopsy(ies)

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

Oesophagoscopy, with or without biopsies. Biopsies are included; add-ons for EMR and Barrett's ablation may be billed with it.

What it covers

Z515 is endoscopy of the oesophagus, with or without biopsy(ies) (S7). Biopsies taken during the oesophagoscopy are part of the fee.

When the stomach (and duodenum) are examined as one procedure, the Schedule also lists Z399, elective oesophagoscopy-gastroscopy with or without duodenoscopy, and Z400 for active bleeding (S7).

Billing rules

• E836, endoscopic mucosal resection of a very large (> 3 cm) upper GI polyp or lesion, may be added to Z515; it requires submucosal injection and piecemeal resection, includes haemostasis, and is limited to 2 per patient per day (S7, S8).
• E813, radiofrequency ablation of dysplastic Barrett's oesophagus, may be added to Z515 (S7).
• Intrathoracic oesophageal stent via oesophagoscope (S083) includes Z515, so Z515 isn't billed with it (S8).
• Z292 laryngoscopy with this endoscopy isn't payable unless done for suspicion of laryngeal disease, and such claims go to manual review with a written explanation; Z293, Z322 and Z323 don't need manual review (S8).
• Upper GI endoscopy done with endoscopic ultrasound S236 or S237 pays zero, unless needed because the echo-endoscope gave limited visualization (S6).
• Multiple IOPs at the same sitting by the same physician are each claimed in full, with pre- and post-operative care counted once (SP4).
• FHO: Z515A is on the Schedule 4 office-procedures list when done in the physician's office for enrolled patients (Agreement p.67 §8.7, p.96).
• 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

• Z527 gastroscopy and Z560 duodenoscopy at the same sitting: multiple IOPs done at the same time by the same physician are each claimed in full, with pre- and post-operative care counted once (SP4). The Schedule also has a single listing for oesophagoscopy-gastroscopy, with or without duodenoscopy, Z399 (S7).
• 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).

Related codes: Z399, Z400, Z527, Z560, E836, E813, Z529

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Oesophagus, page S7; notes S8; EUS note S6.

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