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Billing code

Z119A — Cryotherapy of 5 or more actinic keratoses, same day

Freezing 5+ actinic keratoses

Bill once for liquid nitrogen cryotherapy of at least 5 actinic keratoses on the same day, with diagnostic code 232.

Watch for: Bill one service for the day, not one per lesion; fewer than 5 lesions is Z117.

Code

Z119A

Description

Cryotherapy of 5 or more actinic keratoses, same day

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

Liquid nitrogen cryotherapy of at least 5 actinic keratoses on the same day. Bill with diagnostic code 232; for fewer than 5 lesions use Z117.

What it covers

Z119 is cryotherapy treatment of at least five pre-malignant actinic keratosis lesions on the same day (M5). Freeze-thaw cycles are not included in the count: it is the number of lesions that matters (M5).

It is listed with the excision of pre-malignant lesions codes. As a Z code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4).

Billing rules

• Only eligible for payment when liquid nitrogen is used (M5).
• At least five actinic keratosis lesions must be treated that day; for fewer than five, bill Z117 (M5).
• Submit the claim with diagnostic code 232 (M5).
• If you did the major pre-operative visit in the previous 12 months, only a minor assessment (GP/FP) or a partial assessment (specialist) is payable before the treatment that day; if the decision is made at that day's visit, that visit is the major pre-operative visit and no other assessment before the treatment is payable (GP4, SP4).
• FHO: not listed in Schedule 2 (core services), so not part of the base rate basket (Agreement pp.75–82), and not on the Schedule 4 office procedures list (Agreement pp.94–95).

Often billed with

• A007 intermediate assessment at the visit where the decision to treat is made (GP4, SP4).

Common rejections

• A3H: OHIP's limit for the code was reached. Z119 is a single listing for cryotherapy of at least five actinic keratoses on the same day (M5), not a per-lesion fee: bill one service for the day's treatment, not one per lesion.

Related codes: Z117, R160, R163, R031, R018, A007

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, Excision of pre-malignant lesions, page M5; General Preamble GP4; Surgical Preamble SP4

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