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Z912
Z912 – Myringotomy
OHIP Psychiatric Code — AURAL SURGICAL PROCEDURES · Schedule of Benefits
Myringotomy is a surgical procedure involving an incision of the tympanic membrane (eardrum). This service is performed unilaterally and includes aspiration of middle ear fluid when indicated.<br><br>Note: For an otherwise healthy child, Z912 is only eligible for payment for the treatment of symptomatic chronic otitis media with effusion that has persisted beyond 3 months or for recurrent episodes of acute otitis media with effusion.
When to Use
- Use Z912 for the surgical treatment of symptomatic chronic otitis media with effusion that has persisted for longer than 3 months in an otherwise healthy child.
- Use Z912 for recurrent episodes of acute otitis media with effusion when the clinical criteria for surgical intervention are met.
- Use Z912 for unilateral myringotomy procedures where aspiration of middle ear fluid is performed.
Common Pitfalls
- Billing Z912 in conjunction with Z916 (Intratympanic injection) will result in a rejection, as these services are mutually exclusive.
- Failure to document the duration of effusion (greater than 3 months) or the frequency of recurrent acute episodes in pediatric patients will lead to audit recovery.
- Attempting to bill an assistant fee (Z912B) without prior approval and supporting documentation via M400B will result in automatic rejection.
Billing Tips
- Ensure you apply the correct age-based percentage premium (e.g., AGE_PREMIUM_UNDER_1_YEAR) to the Z912 fee to maximize reimbursement for pediatric patients.
- If performing the procedure after hours or on weekends, ensure the claim meets the non-elective criteria to qualify for E409 or E410 premiums.
Provider Fee$42.15
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
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
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