E005C – Replacement anaesthesiologist
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
When one anaesthesiologist starts a procedure and is replaced by another anaesthesiologist during a surgical procedure or delivery, the service provided by the replacement anaesthesiologist constitutes E005C. This is calculated based on the actual number of time units the replacement is in attendance plus 6 basic units. This code is not applicable for continuous conduction anaesthesia; in those cases, the replacement anaesthesiologist should use the specific continuous conduction anaesthesia fee codes. Each anaesthesiologist involved must document their starting and finishing times in the medical record.
When to Use
- Use E005C when you take over a surgical case from a colleague mid-procedure due to a shift change or emergency, provided it is not a continuous conduction anaesthesia case.
- Use this code when you are the second anaesthesiologist in attendance for a delivery or surgery, ensuring you bill for your specific time units plus the 6 basic units.
Common Pitfalls
- Do not use E005C for continuous conduction anaesthesia; you must bill the specific continuous conduction anaesthesia codes instead.
- Failing to document exact start and finish times in the patient record is a primary cause for audit recovery, as OHIP requires precise time-stamping for both the initial and replacement providers.
- Attempting to bill E005C alongside restricted codes like P014C or P016C will result in an automatic rejection.
Billing Tips
- Ensure the after-hours premium (E400C or E401C) is applied based on the start time of the original case, not the time you took over, to maintain eligibility for the 50% or 75% increase.
No fee information available.
GP. General Preamble
GENERAL PREAMBLE
Procedure
Anaesthesiologists' Services
Each anaesthesiologist must indicate, as part of the medical record, his/her starting and finishing times.
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