E410 – Nights (00:00h – 07:00h) - increase the procedural fee(s) by 75%
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
This premium increases the procedural fee by 75% for services rendered by a physician (other than an Emergency Department Physician) during the night, from 00:00h to 07:00h. This premium is payable only when the following criteria are met: a. The procedure is non-elective; or an elective procedure which, because of an intervening surgical emergency procedure(s), was delayed and commenced between 00:00h and 07:00h. b. The service provided is one of the following: - Non-elective Surgical Procedures (including fractures or dislocations) - Obstetrical Deliveries - Clinical Procedures Associated with Diagnostic Radiological Examinations - Ground Ambulance Transfer (K101) - Air Ambulance Transfer (K111) - Transport of Donor Organs (K102) - Return Trip (K112) - A specified list of Major Invasive Procedures (see applicable codes list). - X112 when required for intussusception.
When to Use
- Apply E410 to non-elective surgical procedures or obstetrical deliveries that commence between 00:00 and 07:00.
- Use E410 for K101 or K111 ambulance transfer codes when the service is initiated within the designated night hours.
- Use E410 for elective procedures that were delayed past midnight due to an intervening surgical emergency.
Common Pitfalls
- Billing E410 for services performed by an Emergency Department Physician, as they are explicitly excluded from this premium.
- Attempting to stack E410 with other after-hours premiums like E409 or E412, which is prohibited by the General Preamble.
- Applying E410 to elective procedures that were scheduled for the night shift rather than delayed by an emergency.
Billing Tips
- Ensure the start time of the procedure is clearly documented in the operative report to justify the 00:00-07:00 window for audit purposes.
- Verify that the base procedural code is eligible for the premium under the General Preamble list before appending E410.
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