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E017

E017ASA IV – patient with incapacitating systemic disease that is a constant threat to life

OHIP Surgical Assists Code · Schedule of Benefits

Extra units payable in addition to basic units when an anaesthesiologist administers an anaesthetic to a patient classified as ASA IV (Physical Status Classification). ASA IV is defined as a patient with incapacitating systemic disease that is a constant threat to life.

When to Use

  • Use E017 for patients with severe, life-threatening conditions such as unstable angina, symptomatic COPD, or recent myocardial infarction that meet the ASA IV criteria.
  • Apply E017 when the patient's systemic disease is incapacitating and poses a constant threat to life, distinguishing it from the 'severe but not incapacitating' criteria required for E022.

Common Pitfalls

  • Billing E017 for patients who are moribund and not expected to survive 24 hours, which should instead be billed as E016.
  • Upcoding from E022 to E017 without clear documentation of the patient's systemic disease being 'incapacitating' and a 'constant threat to life' is a frequent audit trigger.
  • Attempting to bill E017 in conjunction with E100 or P016, which are explicitly restricted from receiving anaesthesia extra units.

Billing Tips

  • Combine E017 with E020 when the ASA IV patient requires emergency surgery, as these are additive premiums.
  • Ensure the ASA classification is determined and documented during the pre-operative assessment, as intra-operative complications do not justify upgrading the ASA status for billing purposes.
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 System.

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