What are the billing rules for Z191A?

Closing the wound with tissue adhesive (such as cyanoacrylate) pays 50% of the fee (M15). Add E542 when done outside hospital. Add E530 if inhalation general anaesthesia (other than 50% N2O/O2) is used and suture is the only procedure. Extensive debridement is E531, on an independent-consideration basis (M15). Not payable with wound or ulcer debridement codes Z080 to Z085 (M10).

What is Z191A often billed with?

E542 when done outside hospital (M15). E530 when inhalation general anaesthesia is used and suture is the sole procedure (M15). E412/E413 or E409/E410 when non-elective and done after hours (GP104).

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Billing code

Z191A — Repair Of Lacerations - More Than 15.1 Cm Other Than Face

Q: What is OHIP billing code Z191A?

Suture repair of a laceration longer than 15.1 cm anywhere other than the face. On the face it is Z192.

Laceration repair, over 15 cm

Bill for repairing a laceration longer than 15.1 cm anywhere other than the face; on the face it is Z192.

Watch for: Tissue adhesive closure pays 50%, and it isn't payable with wound debridement codes Z080 to Z085.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$84.70	$0.00	$0.00	$95.76	$95.76

Code: Z191A
Description: Repair Of Lacerations - More Than 15.1 Cm Other Than Face
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

Suture repair of a laceration longer than 15.1 cm anywhere other than the face. On the face it is Z192.

What it covers

Z191 is repair of a laceration more than 15.1 cm long, other than on the face (M15). Face lacerations of that length are Z192 (M15).

A complex repair of a non-face area is Z188. It needs at least 20 minutes of repair time and either closure of three or more layers or ligation of multiple bleeding vessels (M15).

Billing rules

Closing the wound with tissue adhesive (such as cyanoacrylate) pays 50% of the fee (M15).
Add E542 when done outside hospital. Add E530 if inhalation general anaesthesia (other than 50% N2O/O2) is used and suture is the only procedure. Extensive debridement is E531, on an independent-consideration basis (M15).
Not payable with wound or ulcer debridement codes Z080 to Z085 (M10).
Plastic surgery codes R150 to R154 can't be billed for any laceration repair (M16).
Removal of sutures only is a visit fee (M15).
Z codes are Independent Operative Procedures: if you did the major pre-operative visit in the past 12 months, only a minor assessment (family physician) or partial assessment (specialist) is payable before the procedure that day; if the major pre-operative visit is the same day, no other assessment before it is payable (SP4).
Non-elective surgical procedures started in the evening, on a weekend or holiday, or at night take an after-hours premium: E412 (+20%) or E413 (+40%) for an Emergency Department Physician billing H codes, or E409 (+50%) or E410 (+75%) for other physicians (GP103, GP104).
FHO: a Schedule 4 code that counts toward the office procedures special payment when done in your office for enrolled patients (Agreement p.67 §8.7, p.96).

Often billed with

E542 when done outside hospital (M15).
E530 when inhalation general anaesthesia is used and suture is the sole procedure (M15).
E412/E413 or E409/E410 when non-elective and done after hours (GP104).

Related codes: Z192, Z179, Z190, Z188, Z187, E542, E530

Source: Schedule of Benefits (July 1, 2026), Integumentary System Surgical Procedures, Skin and Subcutaneous Tissue, page M15.

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