Z130 – Radical nail bed destruction - one
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Radical excision of one finger or toe-nail, including the destruction of the nail bed. As this procedure code is prefixed with a '#', specific funding rules apply for the provision of premises, equipment, supplies, and personnel, which are typically covered by the facility's budget (e.g., hospital global budget) and cannot be charged to the patient (). The add-on premium E542 is payable when this service is performed outside of a hospital setting. This procedure has 6 basic units for anaesthesia (Z130C) but is not eligible for payment for a surgical assistant ().
When to Use
- Use Z130 for permanent nail matrix destruction (e.g., phenol matricectomy) for chronic ingrown toenails, distinguishing it from simple nail avulsion (Z131).
- Use this code when the clinical intent is to prevent nail regrowth, which requires the destruction of the nail bed, rather than just the removal of the nail plate.
Common Pitfalls
- Billing Z130 for a simple nail avulsion; if the nail bed is not destroyed, Z131 is the appropriate code.
- Attempting to bill for a surgical assistant; Z130 is explicitly ineligible for assistant fees as noted in the Schedule of Benefits.
- Failing to add E542 when the procedure is performed in a private office setting, which results in under-billing for the service.
Billing Tips
- Always append E542 to your claim when performing this in a community office to capture the facility premium.
- Ensure your documentation explicitly describes the destruction of the nail bed (e.g., chemical cauterization) to justify the use of Z130 over the lower-valued Z131.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
The '#' prefix indicates that for services performed in a hospital, the premises, equipment, supplies, and personnel are funded by the hospital global budget. For services in an ICHSC, these are funded under the <Integrated Community Health Services Centres Act, 2023>. Patients cannot be charged for these items for services rendered outside a hospital or ICHSC.
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