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E500
E500 – Third and subsequent delivery
OHIP Surgical Assists Code — OBSTETRICS · Schedule of Benefits
This fee is an add-on for the delivery of the third and each subsequent infant in a multiple birth scenario. It is claimed in addition to the appropriate primary delivery fee, such as P006, P018, P020, P041, or P042. Its eligibility is subject to specific payment rules based on the method of delivery, gestational age, and whether the fetuses are live or stillborn.
When to Use
- Use E500 for the third and every subsequent infant delivered in a triplet or higher-order multiple birth scenario.
- Apply this code in conjunction with the primary delivery fee (e.g., P006, P018) when the third fetus is successfully delivered, regardless of whether the delivery method is vaginal or caesarean.
Common Pitfalls
- Do not claim E500 for the second infant in a multiple birth; the second infant is covered by the 85% reduction rule for vaginal deliveries or E499 for caesarean sections.
- E500 is strictly ineligible for any delivery between 20 and 23 weeks gestational age, as the Schedule of Benefits restricts payment to the primary delivery fee only during this window.
- Do not bill E500 for stillborn fetuses; the code is only payable for the delivery of live infants.
Billing Tips
- Ensure the primary delivery fee (P006, P018, P041, or P042) is billed first to establish the base procedure before adding E500 for the third and subsequent infants.
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