Z147 – Three or more lesions - Face or neck - General anaesthetic
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Represents a surgical procedure for three or more lesions on the face or neck, performed under general anaesthetic. This procedure is listed in the Schedule of Benefits, typically found in sections M-Z. General rules for surgical procedures apply as outlined in the General Preamble. This includes the application of suffixes 'A' for the surgeon, 'B' for the assistant, and 'C' for the anaesthetist as described on page . Pre-operative assessments for 'Z' prefix procedures are considered part of the surgical service and are not separately billable if the surgeon has assessed the patient for the same illness prior to admission (see ).
When to Use
- Use Z147 when performing the excision or surgical treatment of three or more distinct lesions located specifically on the face or neck under general anaesthetic.
- Select Z147 when the surgical volume meets the 'three or more' threshold, as it is the designated code for this specific anatomical region and anaesthetic requirement.
Common Pitfalls
- Billing Z147 for fewer than three lesions, which will result in a rejection or audit recovery; ensure the operative report clearly identifies at least three distinct sites.
- Attempting to bill a separate pre-operative assessment or hospital admission assessment when the surgeon has already assessed the patient for the same condition prior to admission, as this is included in the Z147 fee.
- Failing to document the ASA physical status classification when claiming associated anaesthesia extra units (E022C, E017C, E016C), which is a mandatory requirement for payment.
Billing Tips
- Ensure the operative report explicitly lists the location and nature of each of the three or more lesions to support the use of Z147 over individual lesion excision codes.
- If the procedure qualifies as non-elective or is delayed by an emergency, apply the appropriate after-hours or night premium (E409 or E410) to the Z147 fee to maximize the claim.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
When claiming the Trauma Premium (E420), the medical record must list the Injury Severity Score (ISS).
When claiming Anaesthesia Extra Units, the patient's age must be documented. For E010C, the patient's BMI must be recorded. For E022C, E017C, and E016C, the ASA level determined at the pre-operative assessment must be documented.
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