Z504 – Excision of lesion
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision of a lesion from the lip. This service is listed in the Digestive System Surgical Procedures section of the Schedule. Assistant services (Z504B) are payable with 6 basic units. Anaesthesia services (Z504C) are payable with 6 basic units. Time units for both assistant and anaesthesia are calculated based on the duration of the procedure. An add-on fee, E542, is payable when this procedure is performed outside of a hospital setting.
When to Use
- Use Z504 for the surgical excision of a lip lesion when the procedure is performed in a hospital setting.
- Use Z504 in combination with E542 when the excision is performed in an office or clinic setting outside of a hospital.
Common Pitfalls
- Billing Z504 alongside a consultation or assessment code for the same patient on the same day without ensuring the procedure is a separate, distinct service.
- Failing to apply the E542 premium when the procedure is performed in an office setting, as this is not automatically triggered by the location code.
- Incorrectly applying age-based premiums; ensure the patient's exact age in days or years is verified against the specific percentage increase tiers.
Billing Tips
- If the procedure is performed after hours, ensure you select the correct premium (E409 or E410) based on the exact start time of the surgery to avoid rejection.
- Always verify if the excision qualifies for the E542 premium by confirming the facility is not classified as a hospital before submission.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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