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E055
E055 – Tendon transfer foot and ankle - each additional
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for each additional tendon transfer performed on the foot and ankle. It is intended to be billed in conjunction with the primary procedure, `R565` - Tendon transfer foot and ankle, single.
When to Use
- Use E055 when performing a second or subsequent tendon transfer during the same operative session as the primary R565 procedure.
- Apply this code when multiple distinct tendons are transferred to address complex foot or ankle deformities, such as in multi-planar correction.
Common Pitfalls
- Billing E055 as a standalone code without the primary R565 will result in an automatic rejection.
- Attempting to use E055 for multiple transfers on the same tendon is incorrect; it must represent a distinct, additional anatomical tendon transfer.
- Failing to clearly document the number of distinct tendon transfers performed in the operative report often leads to audit adjustments.
Billing Tips
- Ensure the operative report explicitly lists each tendon transferred to justify the quantity of E055 units claimed.
- When billing multiple units of E055, ensure the primary R565 is listed first on the claim to establish the base 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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