Z119 – Cryotherapy treatment of at least 5 pre-malignant actinic keratosis lesions
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z119 is a surgical procedure, indicated by its 'Z' prefix. General surgical rules apply. The fee is payable to the physician performing the procedure (suffix A). When a surgical specialist performs an admission assessment for a patient for an illness for which they are subsequently admitted for a 'Z' prefix procedure, the assessment is deemed a specific re-assessment or medical specific re-assessment (see ). The procedure is eligible for age-based premiums for patients under 16 years of age (see ). Z119 is only eligible for payment when liquid nitrogen is used.
When to Use
- Use Z119 when performing cryotherapy on 5 or more distinct actinic keratosis lesions in a single session.
- Use Z119 instead of Z117 when the clinical threshold of 5 lesions is met, as Z117 is restricted to fewer than 5 lesions.
Common Pitfalls
- Billing Z119 alongside an office visit fee (A007) is generally disallowed as the procedure code is considered to include the assessment of the lesions.
- Submitting Z119 without documenting the specific count of at least 5 lesions will lead to clawbacks during an audit.
- Using Z119 for non-cryotherapy treatments, such as topical chemotherapy or curettage, is an invalid use of this specific code.
Billing Tips
- Always ensure diagnostic code 232 is attached to the claim to avoid automatic rejection.
- If treating fewer than 5 lesions, you must bill Z117; do not attempt to 'bundle' multiple Z117 sessions to reach the Z119 fee.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Submit claims with diagnostic code 232.
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