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Billing code

Z157A — Benign skin lesion (Group 1) — excision and suture — two lesions

Two benign skin lesions excised

Bill for excising and suturing two Group 1 benign skin lesions, such as keratoses or pyogenic granulomas.

Watch for: Cosmetic removal without suspicion of disease isn't insured and is billed to the patient.

Code

Z157A

Description

Benign skin lesion (Group 1) — excision and suture — two lesions

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

Removal of two Group 1 benign skin lesions (e.g. keratosis, pyogenic granuloma) by excision and suture.

What it covers

Group 1 lesions are, for example, keratosis and pyogenic granuloma; these codes cover removal by excision and suture (M3).

Z156 is a single lesion, Z157 two lesions and Z158 three or more; removal by electrocoagulation and/or curetting is Z159–Z161 (M3).

Billing rules

• Removal for cosmetic purposes, without clinical suspicion of disease or malignancy, is not insured and is billed to the patient (M3, AD3).
• Appendix D: on the face or neck, excision or destruction is insured when there is any suspicion of disease or malignancy; in other areas it is normally not insured if done only to alter appearance (AD3).
• Add E542 when performed outside hospital (listed under this group; M3).
• Pre-malignant lesions such as actinic keratosis with a pathology report may fit R160–R165 instead (M5).
• A Z code is an independent operative procedure: if your decision-to-operate visit was in the prior 12 months, only a minor (GP) or partial (specialist) assessment is payable before it the same day (SP4 §13).
• FHO: an in-basket core service (Schedule 2, Agreement p.81) with 50% shadow billing (Schedule 2B, p.88), and a Schedule 4 office procedure (p.67 §8.7, p.95).

Often billed with

• E542 outside hospital (M3).

Related codes: Z156, Z158, Z159, Z160, Z161, Z163, R164

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, page M3.

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