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E498
E498 – Debridement (trauma)
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Substantial debridement of 1 or more focal flaps of unstable post-traumatic articular cartilage causing mechanical symptoms, includes when rendered for synovectomy, meniscal trimming and/or chondroplasty.
When to Use
- Use E498 when performing substantial debridement of unstable, post-traumatic articular cartilage flaps that are causing mechanical symptoms like locking or catching.
- Use this code when the procedure includes synovectomy, meniscal trimming, or chondroplasty performed specifically to address the post-traumatic articular pathology.
Common Pitfalls
- Do not bill E498 if the debridement is performed solely for surgical visualization or to clear the field for other procedures, as this is considered inclusive to the primary surgery.
- Avoid billing E498 in combination with E492, E494, or R687, as these are restricted and will trigger automatic claim rejection.
- Failure to document the specific mechanical symptoms and the unstable nature of the cartilage flaps poses a high risk during Ministry audits.
Billing Tips
- When billing E498 with R699, ensure you archive intra-articular photographic evidence of the pathology in the patient's permanent record to substantiate the claim.
- If the procedure is performed after hours or meets trauma criteria, apply the appropriate E409, E410, or E420 premium, ensuring the ISS score is explicitly documented for E420.
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