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E061
E061 – Delayed repair requiring use of tendon graft
OHIP Surgical Assists Code · Schedule of Benefits
When to Use
- Use E061 when performing a distal biceps repair (R183) where the tendon is retracted or degenerated to the point that a primary repair is impossible and an autograft or allograft is required.
- Use E061 when performing a distal triceps repair (R184) involving a chronic tear that necessitates a tendon graft to bridge the gap between the muscle-tendon unit and the olecranon.
Common Pitfalls
- Billing E061 for standard distal biceps or triceps repairs (R183/R184) that are repaired primarily without the use of a graft will result in a rejection or audit recovery.
- Failing to document the specific source of the graft (e.g., palmaris longus autograft or Achilles allograft) will leave the claim vulnerable to audit as the code explicitly requires the use of a graft.
Billing Tips
- Always bill E061 in conjunction with R183 or R184; it is an add-on code that triggers a 50% increase on the base procedure fee.
Provider Fee$0.01
Effective: April 1, 2026
Service Type
Musculoskeletal System Surgical Procedures
Code Classes
Surgery
Requires the use of a tendon graft (allograft or autograft).
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