Z117

PDF page 551 / M1

Biopsy(ies)
              Z116 - any method, when sutures are used ..................................        32.45
              E542    - when performed outside hospital ............................... add      12.65
              Z113 - any method, when sutures are not used ............................          32.45
                  Note:
                  Z116 may be allowed more than once on an IC basis if medically necessary (in order to make a
                  diagnosis or to plan treatment) to biopsy more than one lesion or to obtain a second biopsy
                  from an extensive lesion. If claimed, may be allowed with chemical treatment of lesion (code
                  Z117).

PDF page 555 / M5

EXCISION OF PRE-MALIGNANT LESIONS INCLUDING BIOPSY OF EACH LESION –
       SINGLE OR MULTIPLE SITES
         The amount payable for excision of a pre-malignant lesion will be adjusted to a lesser fee if the
         pathologist’s report is not retained in the patient’s record.
     Face or Neck
       Simple excision
   R160 - single lesion........................................................................    6      58.30    6
   R161 - two lesions..........................................................................    6      95.75    6
   R162 - three or more lesions..........................................................          6     191.45    6
   E542    - when performed outside hospital .............................. add                           12.65
     Other Areas
       Simple excision
   R163 - single lesion........................................................................ 6         47.75    6
   R164 - two lesions.......................................................................... 6         78.65    6
   R165 - three or more lesions..........................................................       6        157.35    6
   E542    - when performed outside hospital ............................... add                          12.65
       Note:
       Excision of a pre-malignant lesion is only payable for the following lesions:
         1.Dysplastic Nevus (nevus with dysplastic features, atypical melanocytic hyperplasia, atypical
           melanocytic proliferation, atypical lentiginous melanocytic proliferation or premalignant
           melanosis)
         2.Actinic/Solar Keratosis
         3.Chemical and other pre-malignant keratoses
         4.Large Cell Acanthoma
         5.Erythroplasia of Queryrat
         6.Leukoplakia
         [Commentary:
         In-situ lesions such as Lentigo Maligna (melanoma-in-situ) and Bowen's Disease (squamous
         cell carcinoma-in-situ) are considered malignant lesions.]
   Z119 Cryotherapy treatment of at least 5 pre-malignant actinic
          keratosis lesions on the same day, not to include freeze-
          thaw cycles.........................................................................            31.80
         Note:
         Z119 is only eligible for payment when liquid nitrogen is used.
         [Commentary:
         For fewer than five lesions see Z117.]
         Claims submission instructions:
         Submit claims with diagnostic code 232.

PDF page 557 / M7

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
 SKIN AND SUBCUTANEOUS TISSUE
                                                                                                 Asst   Surg     Anae
    Other areas
     Curettage, electrodesiccation or cryosurgery
  R031 - single lesion........................................................................    6      60.35    6
  R032 - two lesions..........................................................................    6      99.45    7
  R033 - three or more lesions..........................................................          6     199.05    6
# R051 Laser surgery on Group 1 - 4, pre-malignant and malignant
          lesions (see General Preamble GP12)...............................                            I.C      I.C
     Chemical and/or cryotherapy treatment of skin lesions
   Z117 - Chemical and/or cryotherapy treatment, one or more lesions                  12.75
       Note:
       1.Z117 includes paring and/or debulking of a lesion prior to or subsequent to chemical and/or
         cryotherapy treatment, when rendered.
       2.Z117 is limited to a maximum of one service per patient per physician per day.
         [Commentary:
         See Appendix D (8) of this Schedule for the conditions under which treatment of warts is an
         insured service.]

Master, record 6942. Record Layout PDF, page 1.

Z11720260401999999990000012750000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.