< Billing codes

Billing code

Z560A — Duodenoscopy (not To Be Claimed If Z399 And/or Z400 Performed On Same Patient Within 3 Months)

Duodenum endoscopy

Bill for endoscopy of the duodenum; an assessment can be billed in addition.

Watch for: Not claimable if Z399 or Z400 was done for the same patient within 3 months.

Code

Z560A

Description

Duodenoscopy (not To Be Claimed If Z399 And/or Z400 Performed On Same Patient Within 3 Months)

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

Duodenoscopy. Not claimable if Z399 or Z400 oesophagoscopy-gastroscopy was done for the same patient within 3 months.

What it covers

Z560 is endoscopy of the duodenum, listed under Intestines (Except Rectum) (S15). It is a Z code, so an independent operative procedure payable in addition to an assessment (GP4).

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

Billing rules

• Not to be claimed if Z399 and/or Z400 was performed on the same patient within 3 months (S15).
• Z749, listed directly under Z560, is the subsequent procedure within three months following a previous endoscopic procedure (S15).
• 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 (S15).
• 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).
• Anaesthesia by another physician is the C-suffix claim, 4 basic units (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

• Z527 gastroscopy and Z515 oesophagoscopy 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).
• E629 for endoscopic placement of a stent in the duodenum (S15).
• 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, Z749, Z527, Z515, E629, Z584

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Intestines (Except Rectum), page S15; Z399/Z400 on S7; 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