Z860 – Zeigler punctures
OHIP Psychiatric Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Z860 is a surgical procedure for the repair of entropion (inward turning of the eyelid) or ectropion (outward turning of the eyelid) using the Zeigler punctures technique. This service is distinct from other eyelid repairs like E196 (Entropion) or E197 (Ectropion) which may involve different techniques. If a skin graft is required, refer to the Plastic Surgery Procedures - Integumentary System section of the Schedule.
When to Use
- Use Z860 specifically for the Zeigler puncture technique to correct mild entropion or ectropion when more extensive surgical repairs like E196 or E197 are not clinically indicated.
- Select Z860 for simple, suture-based tightening procedures that do not involve complex tissue excision, flap rotation, or graft placement.
Common Pitfalls
- Billing Z860 in conjunction with E196 or E197 for the same eyelid is considered unbundling and will result in a rejection or audit recovery.
- Attempting to bill Z860 for a full-thickness eyelid reconstruction or complex blepharoplasty will lead to claim rejection as it is intended only for the specific puncture technique.
Billing Tips
- Ensure the operative note explicitly describes the Zeigler puncture technique to justify the use of Z860 over the higher-valued E196 or E197 codes.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures
With skin graft - see Plastic Surgery Procedures - Integumentary System.
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