Z227 – Intramuscular abscess or haematoma
OHIP Psychiatric Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z227 is a surgical procedure, indicated by the 'Z' prefix which typically pertains to fracture and dislocation services. The service is performed by a surgeon (suffix 'A') and requires anaesthesia services (suffix 'C'). The fee for the surgeon is a flat rate. The fee for the anaesthesiologist is calculated based on a base unit value plus time units, as detailed in the 'Anaesthesiologists' Services' section of the Schedule (). Assistant services (suffix 'B') are not payable for this procedure. As a 'Z' prefix code, a hospital admission assessment by the surgeon who has previously assessed the patient for the same illness is deemed a re-assessment, not a new assessment ().
When to Use
- Use Z227 for the surgical drainage of a deep intramuscular abscess where the collection is located within the muscle belly itself, distinguishing it from simple superficial incision and drainage codes.
- Use Z227 for the evacuation of a significant intramuscular haematoma that requires formal surgical intervention, rather than simple aspiration or minor wound care.
Common Pitfalls
- Billing a hospital admission assessment (A-prefix) in addition to Z227 is a common rejection; as a Z-code, the admission assessment is only payable if it qualifies as the 'major pre-operative visit'.
- Attempting to claim a surgical assistant (suffix B) fee for this procedure will result in an automatic rejection, as assistant services are not eligible for Z227.
Billing Tips
- Ensure the anaesthesiologist explicitly records start and finish times in the patient chart, as these are mandatory for calculating the time-based component of the anaesthetic fee.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Anaesthesiologists' Services
All insured services must be documented in appropriate records to 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.
For anaesthesia services, the anaesthesiologist must indicate his/her starting and finishing times as part of the medical record.
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