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E021C
E021C – Anaesthesia for premature newborn less than 37 weeks gestational age
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
An amount is payable for 9 extra units in addition to basic and time units when an anaesthesiologist administers an anaesthetic to a premature newborn of less than 37 weeks gestational age.
When to Use
- Use E021C when providing general or regional anaesthesia to a neonate born at less than 37 weeks gestational age to capture the mandatory 9-unit premium.
- Apply this code in conjunction with the primary anaesthesia service code (e.g., Z001) for any surgical or diagnostic procedure performed on a premature infant.
Common Pitfalls
- Billing E021C alongside E003C, E030C, or E031C will result in an automatic rejection as these codes are mutually exclusive per the General Preamble.
- Failure to verify the gestational age in the patient chart can lead to recovery audits if the infant is found to be 37 weeks or older.
Billing Tips
- Ensure the gestational age is clearly stated in the anaesthesia record to support the claim if audited for the 9-unit premium.
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