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E021

E021Anaesthesia premium for premature newborn < 37 weeks gestational age

OHIP Surgical Assists Code · Schedule of Benefits

An amount payable for extra units in addition to basic units when an anaesthesiologist administers an anaesthetic to a premature newborn less than 37 weeks gestational age.

When to Use

  • Use E021C when providing anaesthesia for a neonate born at less than 37 weeks gestation, regardless of their current chronological age, provided they remain in the neonatal period.
  • Apply this code specifically for premature infants requiring surgical intervention where the anaesthetic risk is elevated due to gestational immaturity.

Common Pitfalls

  • Billing E021C in combination with E014C or E009C is a common error; E021C is a distinct premium for prematurity and should not be stacked with age-based unit modifiers for the same patient.
  • Failure to verify the gestational age in the chart often leads to audit recovery; ensure the specific gestational age is documented to justify the premium over standard age-based codes.

Billing Tips

  • Always append the 'C' suffix to E021 and ensure it is submitted alongside the primary anaesthesia procedure code to trigger the correct unit calculation.
Provider Fee$0.00
Anaesthetist Fee$15.96
Non-Anaesthetist Fee$15.96

Effective: April 1, 2026

Service Type

Anaesthesia

Code Classes

Premium

Extra units are payable in addition to basic units and time units.

The anaesthesiologist unit fee is $15.96.

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