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Z111
Z111 – Frenotomy - not requiring general anaesthetic
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A simple procedure for the release of tongue-tie (frenotomy). This code is for straightforward cases that do not require the complexity or general anaesthesia associated with Z112. As with all insured services, this includes the common elements as described in the Schedule of Benefits (, ).
When to Use
- Use Z111 for a simple, in-office frenotomy performed on an infant or child without the need for general anaesthesia.
- Use Z111 when the procedure is performed as a standalone surgical intervention, distinct from a standard office visit or consultation.
Common Pitfalls
- Billing Z111 in addition to a consultation or assessment code (e.g., A007) on the same day is often rejected unless the assessment is for an unrelated condition or clearly documented as a separate service.
- Confusing Z111 with Z112; Z112 is reserved for complex frenotomies requiring general anaesthesia and will trigger a rejection if the procedure location and anaesthetic status do not match the code definition.
Billing Tips
- Always apply the appropriate age premium (e.g., AGE_PREMIUM_LT_30D) to Z111, as the base fee is low and the premium significantly improves the total reimbursement for pediatric patients.
- Ensure the procedure is clearly identified as a surgical intervention in your billing software to correctly trigger the age-based percentage increases defined in GP64.
Provider Fee$20.00
Effective: April 1, 2026
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
Note: To include nasopharynx, oropharynx, hypopharynx except where otherwise specified.
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