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E016

E016ASA V – moribund patient not expected to live 24 hours with or without operation

OHIP Surgical Assists Code · Schedule of Benefits

An amount is payable for extra units in addition to basic units when an anaesthesiologist administers an anaesthetic to an ASA V patient – a moribund patient not expected to live 24 hours with or without operation.

When to Use

  • Use E016C when managing a patient with multi-organ failure or profound shock where the prognosis is terminal within 24 hours regardless of the surgical intervention.
  • Apply this code for patients presenting with massive intracranial hemorrhage or catastrophic trauma where physiological reserves are exhausted.

Common Pitfalls

  • Billing E016C for organ harvest procedures is a common audit trigger and is explicitly excluded by OHIP policy.
  • Upcoding from E017C (ASA IV) to E016C (ASA V) without clear documentation of the patient's moribund status and 24-hour life expectancy is a high-risk billing error.
  • Submitting E016C alongside E017C or E022C will trigger an automatic rejection as only one ASA physical status premium is permitted per case.

Billing Tips

  • Always pair E016C with E020C if the procedure qualifies as an emergency, as these are additive premiums that maximize the anaesthesia claim value.
  • Ensure the pre-operative assessment note explicitly justifies the ASA V classification to withstand potential Ministry of Health audits.
Provider Fee$0.00
Anaesthetist Fee$15.96
Non-Anaesthetist Fee$15.96

Effective: April 1, 2026

Service Type

Anaesthesia

Code Classes

Premium

ASA stands for American Society of Anesthesiologists Physical Status Classification.

E016C is an 'Extra Unit' premium added to the basic and time units of the primary anaesthesia service.

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