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Z229
Z229 – Tenotomy - closed - one toe
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A closed tenotomy is a surgical procedure for the cutting of a tendon in a single toe, performed via a closed technique, which does not require a large open incision.
When to Use
- Use Z229 for percutaneous release of a tendon in a single toe when no formal open incision is required.
- Select Z229 when performing a closed tenotomy for conditions such as hammer toe or mallet toe deformity where the tendon is released via a needle or small puncture.
Common Pitfalls
- Do not bill Z229 if an open incision is made to expose the tendon, as this would require a different surgical code.
- Z229 is restricted to a single toe; billing multiple toes under one Z229 claim will lead to rejection or audit, as each toe requires a separate line item with the appropriate diagnostic code.
- Attempting to claim an assistant fee directly with Z229 will result in rejection because it is not an assistant-eligible procedure; M400B must be used via the IC process.
Billing Tips
- When performing the procedure on multiple toes, append the appropriate site modifiers (e.g., T1, T2) to each Z229 line item to ensure correct processing.
- If the procedure is performed in an after-hours setting, ensure you apply the relevant E-series premium code to the Z229 fee to capture the 50% or 75% increase.
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