Z253 – Mandible - unilateral
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service involves the unilateral onlay reconstruction of the mandible using either bone grafts or alloplastic materials. This procedure is performed when it is not part of a standard osteotomy reconstruction. Note: The fee listed in the Schedule of Benefits (as of February 14, 2025) is $394.80. As per page , services for harvesting and/or use of homogenous bone grafts may be claimed in addition by referring to the listings on page . Alloplastic materials include high density polyethylene, titanium mesh, resorbable mesh plus composites, calcium phosphate bone cements, and other materials.
When to Use
- Use Z253 for unilateral onlay reconstruction of the mandible using bone grafts or alloplastic materials when the procedure is independent of a standard osteotomy.
- Use Z253 for unilateral mandibular augmentation using materials like titanium mesh or calcium phosphate bone cements, provided it is not part of a larger reconstructive osteotomy.
Common Pitfalls
- Billing Z253 for bilateral procedures; you must use Z254 for bilateral mandibular onlay reconstruction to avoid rejection.
- Failing to claim the additional fee for bone substitutes or banked bone (E553) on the same claim when applicable, as this is a separate billable item under the N3 section guidelines.
Billing Tips
- Always verify if the procedure qualifies for the E553 add-on for banked bone or bone substitutes to maximize the claim value for material costs.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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