E022C – ASA III - patient with severe systemic disease limiting activity but not incapacitating
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
Provides 2 extra units, in addition to the basic and time units, when an anaesthesiologist administers an anaesthetic to a patient with an American Society of Anesthesiologists (ASA) Physical Status Classification of III. An ASA III patient is defined as a patient with severe systemic disease that limits activity but is not incapacitating. This classification must be determined by the anaesthesiologist during the pre-operative anaesthesia assessment.
When to Use
- Use for patients with stable but severe systemic conditions, such as poorly controlled hypertension or stable angina, that necessitate a higher level of perioperative vigilance.
- Apply when the patient meets ASA III criteria for elective procedures, including those eligible for E023C or E032C, to reflect the increased complexity of anaesthetic management.
Common Pitfalls
- Attempting to bill E022C alongside E003C for supportive care or monitoring, which is explicitly prohibited by the Schedule of Benefits.
- Failing to document the specific ASA classification in the pre-operative assessment, which is a mandatory requirement for audit compliance.
- Upcoding to E017C (ASA IV) when the patient's condition is severe but does not represent a constant threat to life.
Billing Tips
- Always append E020C to your E022C claim if the surgery meets the emergency criteria of commencing within 24 hours of the operating room booking.
- Ensure the ASA classification is determined at the time of the pre-operative assessment, as intraoperative complications do not retroactively justify upgrading the ASA status.
No fee information available.
GP. General Preamble
GENERAL PREAMBLE
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Anaesthesiologists' Services
The ASA level for Physical Status Classification must be determined by the anaesthesiologist at the time of the pre-operative anaesthesia assessment and documented in the patient's medical record.
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