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Billing code

Z128A — Simple, partial or complete nail plate excision req. anaesthesia

Nail removal, one nail

Bill for simple, partial or complete excision of one finger or toe nail plate when anaesthesia is needed.

Watch for: For more than one nail bill Z129; nail trimming or clipping isn't insured.

Code

Z128A

Description

Simple, partial or complete nail plate excision req. anaesthesia

FHO+ basket

Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Simple, partial or complete excision of one finger or toe nail plate when anaesthesia is needed. For more than one nail, bill Z129.

What it covers

Z128 is a simple, partial or complete nail plate excision of one finger or toe nail, requiring anaesthesia (M23). Radical excision that also destroys the nail bed is Z130 (M23).

Trimming or clipping of nails is not an insured service, and extensive debridement of an onychogryphotic nail with removal of multiple laminae is Z110 (M23). As a Z code it is an independent operative procedure (IOP), payable in addition to an assessment (GP4).

Billing rules

• Bill Z128 for one nail; for more than one nail use Z129 (M23).
• A local anaesthetic or nerve block you give for your own procedure is not paid separately; the exception is G224 for a post-operative pain block lasting more than 4 hours (SP5).
• E542 is added when the procedure is done outside hospital (M23).
• Not eligible for payment in addition to a complex laceration repair (Z187, Z188 or Z189) for the same repair (M16).
• 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 procedure 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 procedure is payable (GP4, SP4).
• FHO: a Schedule 2 core service and one of the Schedule 2B codes with 50% total shadow billing for enrolled patients; it also counts toward the Schedule 4 office procedures payment when done in the office (Agreement p.59 §4.4, p.80, p.87, p.67 §8.7, p.94).

Often billed with

• E542 when the procedure is done in the office or elsewhere outside hospital (M23).
• A partial assessment, such as A034 (General Surgery), before the procedure when you did the major pre-operative visit in the previous 12 months (SP4).

Related codes: Z129, Z130, Z131, Z110, E542

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, Finger or toe-nail, page M23; Surgical Preamble SP4 and SP5

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