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E057
E057 – Revision/repair following previous rotator cuff surgery
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Revision/repair following previous rotator cuff surgery
When to Use
- Use E057 when performing a secondary surgical intervention on a rotator cuff that has previously undergone a primary repair, as it specifically accounts for the increased complexity of revision surgery.
- Apply this code when the operative note confirms the procedure is a re-operation on a previously repaired tendon, distinguishing it from a primary repair billed under R594.
Common Pitfalls
- Billing E057 for a primary rotator cuff repair instead of the appropriate R594 will result in a rejection or audit recovery due to the incorrect surgical classification.
- Failing to clearly document the previous surgical history and the specific findings of the failed repair in the operative report often leads to claim denials for this revision-specific code.
Billing Tips
- Ensure the operative report explicitly details the scar tissue excision or hardware removal associated with the revision to justify the use of E057 over standard primary repair codes.
Provider Fee$0.01
Effective: July 1, 2013
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Other
Code Classes
Musculoskeletal System Surgical Procedures
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