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E048
E048 – Pseudoarthrosis - intramedullary nail with distal and proximal locking screws - femur
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents an additional fee for the use of an intramedullary nail with distal and proximal locking screws for the reconstruction of pseudoarthrosis of the femur. It must be billed in conjunction with a primary pseudoarthrosis femur procedure.
When to Use
- Use this code as an add-on to primary pseudoarthrosis repair procedures (e.g., F095, F096) specifically when an intramedullary nail with both proximal and distal locking screws is utilized for internal fixation.
- Apply this code when the clinical documentation confirms the use of a locked intramedullary nail construct specifically for the management of femoral non-union or pseudoarthrosis.
Common Pitfalls
- Billing E048 as a standalone procedure; it is an add-on code and will be rejected if not submitted on the same claim as the primary femoral pseudoarthrosis procedure.
- Attempting to bill E048 when using standard plating or non-locked intramedullary devices, which do not meet the specific technical requirements of this code.
- Failure to link the code to the primary procedure, which can lead to automated rejections if the claim structure does not clearly associate the add-on with the base surgical fee.
Billing Tips
- Ensure the operative report explicitly mentions the use of both proximal and distal locking screws to support the claim during potential post-payment audits.
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