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Z266
Z266 – Split cranial graft
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z266 is a surgical procedure for harvesting a split cranial graft. This service is intended to be billed when the harvesting of the bone graft is not an included component of the primary surgical procedure being performed. As noted on page , several orbito-cranial procedures (e.g., R376, R391) already include the harvesting and grafting of bone, in which case Z266 would not be separately payable.
When to Use
- Use Z266 when harvesting a split cranial graft as a standalone procedure or as an adjunct to a surgery that does not already include bone harvesting in its fee description.
- Use Z266 when the graft is required for a reconstructive procedure where the primary surgical code (e.g., non-orbito-cranial procedures) does not explicitly state that graft harvesting is a component of the service.
Common Pitfalls
- Billing Z266 alongside orbito-cranial procedures like R376 or R391 will result in an automatic rejection, as these codes include graft harvesting in their global fee.
- Attempting to bill Z266 with E932, E934, or E935 is prohibited; these codes are mutually exclusive on the same day of service.
- Failing to verify if the primary procedure's description includes 'harvesting' or 'grafting' leads to frequent audit adjustments for unbundling.
Billing Tips
- Always cross-reference the primary surgical code against the restricted list on page N33/N34 to ensure the graft harvesting is not already bundled into the primary procedure fee.
- If the patient meets the criteria for age-based premiums, ensure they are applied to Z266 as it falls within the Part Z surgical schedule.
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