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E090
E090 – Removal of contralateral ovary with moderate or severe endometriosis
OHIP Surgical Assists Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This code provides an additional fee for the removal of one or both ovaries in the presence of moderate or severe endometriosis. It is billed in addition to:
- `S757, S758, or S759 for the removal of one or both ovaries with moderate or severe endometriosis during a hysterectomy.
- S745` for the removal of the contralateral ovary with moderate or severe endometriosis during an oophorectomy and/or oophorocystectomy.
When to Use
- Use E090 when performing an oophorectomy (S745) where the contralateral ovary is removed specifically due to moderate or severe endometriosis.
- Use E090 as an add-on to hysterectomy codes (S757, S758, or S759) when the surgical removal of one or both ovaries is necessitated by moderate or severe endometriosis.
Common Pitfalls
- Billing E090 for routine oophorectomy without explicit documentation of moderate or severe endometriosis will lead to claim rejection.
- Attempting to bill E090 for bilateral oophorectomy performed for reasons other than endometriosis, such as prophylactic removal or benign cysts, is an audit risk.
- Billing E090 with S745 when only one ovary is removed; E090 specifically requires the removal of the contralateral ovary in the context of endometriosis.
Billing Tips
- Ensure your operative report clearly describes the severity of the endometriosis (e.g., ASRM stage III or IV) to justify the premium code E090.
- When billing S745, ensure the claim reflects the removal of the contralateral ovary to satisfy the specific criteria for the E090 add-on.
Provider Fee$260.80
Effective: April 1, 2025
Category
V. Female Genital Surgical Procedures
Subcategory
FEMALE GENITAL SURGICAL PROCEDURES
Service Type
Premium
Code Classes
Female Genital Surgical Procedures
Sex Restriction
Female
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