Z522 – Excision small tumour
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision small tumour is a surgical procedure listed under the Digestive System, specifically for the Salivary Glands and Ducts. The procedure has defined basic units for both surgical assistance and anaesthesia.
When to Use
- Use Z522 for the excision of a small, benign salivary gland tumour or ductal lesion when the procedure does not meet the criteria for more complex excision codes like S102.
- Select Z522 when performing a minor surgical excision of a localized salivary mass that is clearly defined as a small tumour, distinguishing it from simple biopsies or drainage procedures.
Common Pitfalls
- Billing Z522 in addition to a major procedure performed during the same anaesthetic session is a common error, as OHIP only pays the basic units for the major procedure.
- Failing to document the specific size or nature of the tumour can lead to audit rejections if the claim is flagged as potentially requiring a more complex excision code.
Billing Tips
- Ensure that if you are acting as the surgeon, you do not bill for an admission assessment unless it qualifies as the 'major pre-operative visit' where the decision to operate was finalized.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
All insured services must be documented in appropriate records that establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
For time-based services (anaesthesia, assistant), the physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.