All codes
Z128
Z128 – Simple, partial or complete, nail plate excision requiring anaesthesia - one
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use Z128 for a single nail avulsion performed under local digital block anesthesia for conditions like ingrown toenails or subungual hematoma.
- Use Z128 when the procedure is limited to the nail plate excision, as opposed to Z129 which is mandatory if you are treating two or more nails during the same encounter.
Common Pitfalls
- Billing Z128 multiple times for multiple nails will result in automatic rejection; you must use Z129 for the second and subsequent nails.
- Failing to append E542 when performing the procedure in a community clinic or office setting results in the loss of the facility-based supplement.
Billing Tips
- Always ensure E542 is included on the same claim as Z128 when the procedure occurs in your office to capture the full allowable fee.
- If the procedure is performed after hours, ensure you apply the appropriate After Hours Procedure Premium in addition to Z128 and E542 to maximize the claim value.
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