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Z757
Z757 – Excision of benign anal lesion(s)
OHIP Psychiatric Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of benign anal lesion(s). This surgical procedure is eligible for payment for a surgeon (suffix A), assistant (suffix B), and anaesthesiologist (suffix C). The assistant's fee is calculated based on 6 base units plus time units (see ). The anaesthesiologist's fee is calculated based on 6 base units plus time units (see ). An additional premium, E542, is payable when this service is rendered outside of a hospital.
When to Use
- Use Z757 for the surgical excision of benign anal lesions such as skin tags or benign polyps when performed in an office or hospital setting.
- Use Z757 when the procedure involves a formal excision; do not use this code for simple cauterization or destruction of lesions, which may be covered under different minor procedure codes.
Common Pitfalls
- A common error is billing Z757 alongside a consultation or assessment code on the same day without a valid diagnostic code indicating a separate, unrelated clinical issue.
- Failing to append the E542 premium when performing the excision in a physician's office is a frequent missed revenue opportunity.
Billing Tips
- If performing the procedure in your office, ensure E542 is submitted on the same claim to capture the $11.55 premium.
- Always verify the patient's age at the time of service, as Z757 is subject to significant age-based percentage premiums ranging from 10% to 30% for patients under 16 years of age.
Provider Fee$47.15
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
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