Z260 – Temporal - bilateral
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Onlay bone grafts or alloplastic reconstruction to the face when not part of standard osteotomy for reconstruction, specifically for the bilateral temporal region. Alloplastic materials may include high density polyethylene, titanium mesh, resorbable mesh plus composites, calcium phosphate bone cements and other materials. Note: Services for harvesting and/or using homogenous bone grafts may be claimed in addition as per page .
When to Use
- Use for bilateral temporal augmentation using alloplastic materials like titanium mesh or high-density polyethylene for reconstructive purposes.
- Use when performing bilateral temporal onlay grafting that is distinct and separate from a standard osteotomy procedure.
- Use when applying calcium phosphate bone cements bilaterally to the temporal region for contour restoration.
Common Pitfalls
- Billing Z260 as part of a standard osteotomy; the Schedule of Benefits explicitly excludes this code when the graft is part of a standard reconstruction.
- Failing to document the specific alloplastic material used, which is required to justify the use of this surgical code over other musculoskeletal procedures.
- Attempting to claim Z260 for unilateral procedures; ensure the documentation confirms bilateral involvement to avoid rejection or audit recovery.
Billing Tips
- Always append the appropriate bone graft harvesting code from the N3 section if homogenous bone was harvested and used in conjunction with the alloplastic reconstruction.
- Ensure the operative report clearly distinguishes the temporal onlay graft from any other concurrent procedures to prevent claims of unbundling.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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