Z123 – Two lesions
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure within the Musculoskeletal System section of the Schedule of Benefits. As a Z-prefix code, it is subject to the general rules for surgical procedures outlined in the OHIP Schedule of Benefits. This includes specific rules for pre-operative assessments (, ), post-operative visits (, ), and eligibility for age-based fee premiums (). The master fee record indicates that fees for assistant (suffix B) and anaesthetist (suffix C) services are not payable for this code. Specific details for this procedure are not provided in the source context.
When to Use
- Use Z123 when excising or treating exactly two distinct musculoskeletal lesions during a single operative session.
- Select Z123 over Z122 when the clinical documentation confirms the removal or treatment of a second lesion that meets the criteria for this specific code.
Common Pitfalls
- Attempting to bill Z123 in conjunction with Z122 or Z124 for the same anatomical site will result in a rejection for duplicate or overlapping services.
- Submitting for an assistant (suffix B) or anaesthetist (suffix C) will trigger an automatic rejection as these services are explicitly non-payable for Z123.
Billing Tips
- Always append E542 to the claim if the procedure is performed in an office or clinic setting outside of a hospital to capture the additional $12.65 fee.
- Ensure the operative report clearly identifies two distinct lesions to justify the use of Z123 rather than a single-lesion code, as this is the primary focus of post-payment audits.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Diagnostic and Therapeutic Procedures
For those procedures prefixed with a “Z”, an admission assessment by a surgical specialist who has assessed the patient prior to admission for the same illness is deemed to be a specific re-assessment or medical specific re-assessment.
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