E025C – Unanticipated massive transfusion
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
An amount is payable for 10 extra units in addition to basic and time units when an anaesthesiologist administers an anaesthetic to a patient experiencing an unanticipated massive transfusion. This is defined as a transfusion of at least one blood volume of red blood cells. Note: E025C is only eligible for payment for an unanticipated transfusion of blood during a surgical procedure where: 1. greater than 70 ml/kg of red blood cells are transfused for a patient with a weight up to 50 kg; or 2. 10 or more units of red blood cells are transfused for a patient with a weight exceeding 50 kg. Commentary: E025C is defined by the amount of blood transfused rather than the amount of blood loss. The volume of blood transfused does not include blood collected from a cell saver, hemodilution techniques or non-red blood cell components.
When to Use
- Use when a patient exceeding 50 kg requires 10 or more units of red blood cells during an unanticipated surgical hemorrhage.
- Use for pediatric or low-weight patients (under 50 kg) when the total volume of red blood cells transfused exceeds 70 ml/kg.
Common Pitfalls
- Including blood salvaged via cell saver or hemodilution techniques in the unit count, which is strictly prohibited by the General Preamble.
- Attempting to bill E025C for massive blood loss that did not reach the specific red blood cell unit threshold, even if the clinical situation was critical.
- Counting non-red blood cell components like FFP, platelets, or cryoprecipitate toward the 10-unit threshold required for patients over 50 kg.
Billing Tips
- Ensure the anesthesia record clearly documents the specific number of red blood cell units administered to support the claim during a potential audit.
- Bill E025C as an add-on to your primary anesthetic base and time units (e.g., E009C or E010C) to ensure it is processed correctly as a premium.
No fee information available.
GP. General Preamble
GENERAL PREAMBLE
Premium
Anaesthesiologists' Services
E025C is only eligible for payment for an unanticipated transfusion of blood during a surgical procedure where: 1. greater than 70 ml/kg of red blood cells are transfused for a patient with a weight up to 50 kg; or 2. 10 or more units of red blood cells are transfused for a patient with a weight exceeding 50 kg.
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