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E411
E411 – Sole delivery premium
OHIP Surgical Assists Code — OBSTETRICS · Schedule of Benefits
When to Use
- Use E411 when you are the sole physician responsible for a delivery (e.g., P006A or E414) and no other delivery occurs on that same calendar day.
- Apply this premium when you perform a vaginal delivery (P018A or P020A) as the primary provider without sharing the delivery fee with a partner or resident.
Common Pitfalls
- Billing E411 when you have performed more than one delivery on the same calendar day, as the premium is strictly for a 'sole' delivery.
- Exceeding the annual cap of 25 claims per fiscal year, which will result in automatic rejections for subsequent claims.
- Attempting to bill E411 when you have split the delivery fee (P006A/E414) with another physician, as this violates the 'sole' delivery requirement.
Billing Tips
- Track your annual count of E411 claims closely throughout the fiscal year to ensure you do not exceed the 25-claim limit, as these are non-recoverable once the cap is reached.
Percentage Premium: 1%
This code applies a percentage increase to the base procedure fee
Provider Fee$0.00
Effective: July 1, 2013
Category
K. Obstetrics
Subcategory
OBSTETRICS
Service Type
PercentageIncrease
Code Classes
Obstetrics, Other Premiums (including After Hours Procedure Premiums)
Sex Restriction
Female
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