Z257 – Zygoma - unilateral
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z257 represents a unilateral onlay bone graft or alloplastic reconstruction to the zygoma (cheekbone), when this procedure is not performed as a component of a standard osteotomy for reconstruction. Alloplastic materials may include high density polyethylene, titanium mesh, resorbable mesh plus composites, calcium phosphate bone cements, and other materials as noted in the Schedule commentary. As per the note on page of the Schedule of Benefits, services for harvesting and/or use of homogenous bone grafts may be claimed in addition to Z257. Refer to page for appropriate listings.
When to Use
- Use Z257 for unilateral zygomatic augmentation using alloplastic materials like titanium mesh or high-density polyethylene when performed as a standalone procedure.
- Select Z257 for unilateral contour correction of the zygoma using bone cements or grafts that are not part of a larger complex osteotomy or fracture reduction procedure.
Common Pitfalls
- Billing Z257 in conjunction with complex facial osteotomies where the zygomatic reconstruction is considered an integral component of the primary procedure, leading to rejection for unbundling.
- Failing to bill E553 separately when a homogenous bone graft is utilized, as the fee for Z257 does not inherently include the cost or effort of the graft material.
Billing Tips
- Always append E553 to your claim if you are using banked bone or bone substitutes to ensure you are compensated for the additional material usage beyond the base Z257 fee.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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