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E041

E041Pseudoarthrosis - intramedullary nail with distal and proximal locking screws - tibia

OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Pseudoarthrosis - intramedullary nail with distal and proximal locking screws - tibia

When to Use

  • Use E041 specifically for the surgical management of a tibial non-union requiring revision or stabilization with an intramedullary nail featuring both proximal and distal locking.
  • Select this code when the clinical documentation confirms a pseudoarthrosis diagnosis, distinguishing it from a primary fracture fixation procedure like R063.

Common Pitfalls

  • Billing E041 in conjunction with primary fracture fixation codes is often rejected as it is intended for non-union revision, not initial trauma management.
  • Failure to include the required diagnostic code for non-union (e.g., ICD-9 733.82) will result in an automatic rejection for this specific procedure code.

Billing Tips

  • Ensure the operative report explicitly details the removal of previous hardware or the specific technique used to address the pseudoarthrosis to justify the use of this specialized code over standard fixation codes.
Provider Fee$81.55

Effective: April 1, 2025

Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Other

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