Z261 – Frontal - unilateral
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs a unilateral onlay bone graft or alloplastic reconstruction of the frontal bone of the face. This procedure is indicated when it is not part 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. Services for harvesting and/or use of homogenous bone grafts may be claimed in addition (see page for listings).
When to Use
- Use Z261 for unilateral onlay bone grafting or alloplastic reconstruction of the frontal bone when the procedure is performed as a standalone reconstruction rather than as part of a standard osteotomy.
- Select Z261 when utilizing alloplastic materials such as titanium mesh, high-density polyethylene, or calcium phosphate bone cements for frontal contour correction.
Common Pitfalls
- Do not bill Z261 if the frontal reconstruction is already included as part of a more comprehensive osteotomy procedure, as this constitutes unbundling.
- Failure to include the E553 fee code when using banked bone or bone substitutes results in lost revenue, as E553 is specifically payable in addition to Z261.
Billing Tips
- Always append the E553 fee code to your claim when using bone substitutes to capture the additional $25.15 payment for materials.
- Ensure the operative report clearly distinguishes the onlay graft from any concurrent osteotomy to justify the use of Z261 as a separate surgical event.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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