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E053

E053Tendon transfer foot and ankle - each additional

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

This code is used for each additional tendon graft performed on the foot or ankle. It is intended to be billed as an add-on to the primary procedure, R560A (Tendon Graft - foot and ankle), for each subsequent graft performed during the same operation.

When to Use

  • Use E053 for every additional tendon graft performed beyond the first graft, which is billed under the primary code R560A.
  • Apply this code when performing multi-tendon transfers in a single operative session where each subsequent transfer requires a distinct graft procedure.

Common Pitfalls

  • Billing E053 as a standalone procedure without the primary R560A code will result in an automatic rejection.
  • Attempting to use E053 for the first tendon graft instead of R560A is a common error that leads to claim adjustment or denial.
  • Failure to clearly document the number of distinct grafts performed can lead to recovery during an audit if the claim exceeds the expected number of procedures.

Billing Tips

  • Ensure the total number of E053 units billed corresponds exactly to the number of additional grafts performed beyond the initial R560A procedure.
Provider Fee$94.60

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

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