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E493
E493 – Drilling of defect
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Drilling of defect is a surgical procedure performed on the knee. This service includes the removal of loose body(ies) as a constituent element.
When to Use
- Use E493 for the surgical drilling of osteochondral defects or subchondral bone cysts in the knee joint.
- Use E493 when the procedure involves the removal of loose bodies as a component of the drilling process, as this is explicitly included in the code definition.
Common Pitfalls
- Do not bill separately for the removal of loose bodies, as this is considered a constituent element of E493 and is not eligible for additional payment.
- Avoid billing E493 in conjunction with other knee arthroscopy codes if the work is considered part of the same surgical approach or site, as this may trigger a duplicate service rejection.
Billing Tips
- Ensure the operative report clearly details the drilling technique used, as this is the primary justification for the E493 fee.
- If the procedure is performed after hours or on a trauma patient, verify that you meet the specific criteria for E409, E410, or E420 before appending these premiums to the E493 claim.
Provider Fee$251.55
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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