All codes
Z903
Z903 – Pre-auricular sinus
OHIP Psychiatric Code — AURAL SURGICAL PROCEDURES · Schedule of Benefits
Surgical excision of a pre-auricular sinus. This service is for procedures not requiring a general anaesthetic; use E309 for cases under general anaesthetic. The fee for Z903 includes the local anaesthetic administered by the performing physician. This service includes all common and specific elements for a surgical procedure as outlined in the Schedule of Benefits (see , ).
When to Use
- Use Z903 for the definitive surgical excision of a pre-auricular sinus tract performed under local anaesthetic in an office or clinic setting.
- Use Z903 when the procedure is performed as a standalone surgical event, as the fee includes the local anaesthetic administration.
Common Pitfalls
- Billing Z903 in conjunction with a separate office visit code (A007) for the same encounter is a common rejection, as the surgical fee includes the assessment required for the procedure.
- Attempting to bill for the local anaesthetic separately will trigger a rejection, as it is explicitly bundled into the Z903 fee per the Schedule of Benefits.
- Using Z903 for cases requiring general anaesthetic is an audit risk; E309 must be used for those specific hospital-based scenarios.
Billing Tips
- Always apply the appropriate age-based premium (e.g., AGE_PREMIUM_UNDER_16_YEARS) to Z903 if the patient qualifies, as these are eligible add-ons for surgical procedures.
- Ensure the operative note clearly describes the excision of the sinus tract to support the surgical code, distinguishing it from a simple incision and drainage.
Provider Fee$62.95
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
AURAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Ocular and Aural Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.