All codes
Z267
Z267 – Augmentation of zygoma (bilateral) - with prosthetic implant
OHIP Psychiatric Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Z267 is for the bilateral augmentation of the zygoma using a prosthetic implant. It is categorized under surgical procedures for the correction of Down's syndrome facial stigmata as detailed on page of the Schedule of Benefits.
When to Use
- Use Z267 specifically for the bilateral surgical placement of prosthetic implants to augment the zygomatic region in patients with Down's syndrome.
- Select Z267 when the procedure is performed to correct facial stigmata associated with Down's syndrome as defined in the Schedule of Benefits, Section N34.
Common Pitfalls
- Billing Z267 for cosmetic zygomatic augmentation in patients without a documented diagnosis of Down's syndrome will result in claim rejection or audit recovery.
- Attempting to bill a hospital admission assessment separately is prohibited; per GP40, the surgeon's admission assessment is considered part of the surgical package unless it qualifies as the major pre-operative visit.
- Confusing Z267 with unilateral procedures (such as Z268) will lead to billing inaccuracies, as Z267 is strictly defined for bilateral augmentation.
Billing Tips
- Ensure the patient's diagnosis of Down's syndrome is clearly documented in the chart to support the medical necessity of this specific surgical code.
- If the procedure is performed after hours, verify eligibility for E409 or E410, but note that these cannot be combined with the E420 trauma premium.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.