E017C – ASA IV – patient with incapacitating systemic disease that is a constant threat to life
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
E017C adds 10 extra units to the anaesthetic fee when an anaesthesiologist administers an anaesthetic to a patient with an incapacitating systemic disease that is a constant threat to life (ASA Physical Status IV). The ASA level is determined by the anaesthesiologist during the pre-operative assessment and is not altered by complications arising during surgery. This premium is not payable for anaesthesia rendered to a brain-dead patient for organ donation.
When to Use
- Use E017C for patients with severe, life-threatening systemic conditions, such as unstable angina, symptomatic COPD, or recent myocardial infarction, that meet the ASA IV criteria.
- Apply this code when the patient's pre-operative status is classified as ASA IV, regardless of whether the surgery is elective or urgent.
Common Pitfalls
- Billing E017C for patients who are brain-dead for organ donation is strictly prohibited and will result in recovery during an audit.
- Attempting to claim E017C for intra-operative complications that increase the patient's risk level is incorrect, as the ASA status must be determined during the pre-operative assessment.
- Submitting E017C alongside restricted codes E003C, E030C, or E031C will result in an automatic rejection.
Billing Tips
- Always append the emergency add-on code E020C when the ASA IV surgery commences within 24 hours of the operating room booking to maximize the unit value.
No fee information available.
GP. General Preamble
GENERAL PREAMBLE
Anaesthesia Extra Unit
Anaesthesiologists' Services
The ASA IV classification must be determined by the anaesthesiologist at the time of the pre-operative anaesthesia assessment and documented in the medical record.
In the description of E017C, reference to ASA level for Physical Status Classification means the level determined by the anaesthesiologist at the time of the pre-operative anaesthesia assessment.
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