What are the billing rules for Z111A?

Add E542 when Z111 is performed outside hospital (S1). As a Z code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4). If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or partial assessment (specialist) is payable before the procedure that day; if the decision to operate is made that day, that visit is billable but no other assessment before the procedure (SP4). Age premiums apply to surgical procedures for children under 16: 30% under 30 days, 25% from 30 days to under 1 year, 20% from 1 to under 2 years, 15% from 2 to under 5, 10% from 5 to under 16 (GP64).

What is Z111A often billed with?

E542 when performed in the office or another setting outside hospital (S1). A consultation or assessment, for example A905 limited consultation, at the visit where the decision to treat is made (GP4, SP4).

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Billing code

Z111A — Frenotomy - Simple Not Requiring General Anaesthetic

Q: What is OHIP billing code Z111A?

Frenotomy (tongue-tie release) that doesn't need a general anaesthetic. Frenotomy under GA, or frenectomy, is Z112.

Tongue-tie release

Bill for a frenotomy (tongue-tie release) that doesn't need a general anaesthetic.

Watch for: A frenotomy under general anaesthetic, or a frenectomy, is Z112; add E542 outside hospital.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$20.00	$0.00	$0.00	$0.00	$0.00

Code: Z111A
Description: Frenotomy - Simple Not Requiring General Anaesthetic
FHO+ basket: Not in the FHO+ base rate basket (Schedule 2 or 2B).
Effective date: Apr 1, 2026
Termination date: No end date

Explanation

Updated October 26, 2026

Frenotomy (tongue-tie release) that doesn't need a general anaesthetic. Frenotomy under GA, or frenectomy, is Z112.

What it covers

Z111 is frenotomy not requiring general anaesthetic, listed under Oral Cavity and Pharynx (S1). Frenotomy requiring a general anaesthetic, or a frenectomy, is Z112 (S1).

Any physician who performs the procedure bills it; outside the Consultations and Visits section, 'surgeon' in the Schedule means any physician performing the procedure (SP2).

Billing rules

Add E542 when Z111 is performed outside hospital (S1).
As a Z code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4). If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or partial assessment (specialist) is payable before the procedure that day; if the decision to operate is made that day, that visit is billable but no other assessment before the procedure (SP4).
Age premiums apply to surgical procedures for children under 16: 30% under 30 days, 25% from 30 days to under 1 year, 20% from 1 to under 2 years, 15% from 2 to under 5, 10% from 5 to under 16 (GP64).

Often billed with

E542 when performed in the office or another setting outside hospital (S1).
A consultation or assessment, for example A905 limited consultation, at the visit where the decision to treat is made (GP4, SP4).

Related codes: Z112, E542, A905, Z501

Source: Schedule of Benefits (July 1, 2026), Digestive System Surgical Procedures, Oral Cavity and Pharynx, page S1; age premiums GP64; Surgical Preamble SP2 and SP4.

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