What are the billing rules for Z542A?

If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or a partial assessment (specialist) is payable before the procedure that day (SP4). If the decision to operate is made at that day's visit, that visit is the major pre-operative visit; no other consultation or assessment before the procedure that day is payable (GP4, SP4). When an IOP is done the same day as a non-IOP procedure, the surgeon can't bill the hospital or day care admission assessment unless it is the major pre-operative visit (SP4).

What is Z542A often billed with?

An assessment at the visit where the decision to treat is made, billable as the major pre-operative visit (GP4, SP4).

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Billing code

Z542A — Intubation of bile duct for obstruction

Q: What is OHIP billing code Z542A?

Intubation of a bile duct for obstruction. A Z-code independent operative procedure, so an assessment can also be paid under the IOP rules.

Bile duct intubation

Bill for intubating a bile duct for obstruction; as an independent procedure, an assessment can be paid in addition.

Watch for: If the major pre-operative visit was earlier, only a minor or partial assessment is payable before the procedure that day.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$85.25	$0.00	$0.00	$0.00	$0.00

Code: Z542A
Description: Intubation of bile duct for obstruction
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

Intubation of a bile duct for obstruction. A Z-code independent operative procedure, so an assessment can also be paid under the IOP rules.

What it covers

Z542 is intubation of a bile duct for obstruction. It is a separate listing in the Biliary Tract sub-section, placed after Z562 (manipulation and/or removal of bile duct stones via a T-tube tract, as sole procedure) (S30).

As a Z code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4, SP4). 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).

Billing rules

If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or a partial assessment (specialist) is payable before the procedure that day (SP4).
If the decision to operate is made at that day's visit, that visit is the major pre-operative visit; no other consultation or assessment before the procedure that day is payable (GP4, SP4).
When an IOP is done the same day as a non-IOP procedure, the surgeon can't bill the hospital or day care admission assessment unless it is the major pre-operative visit (SP4).

Often billed with

An assessment at the visit where the decision to treat is made, billable as the major pre-operative visit (GP4, SP4).

Related codes: Z562, Z593, S233, S234, Z561, Z558

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Biliary Tract, page S30; Surgical Preamble SP4; General Preamble GP4, GP13

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