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E502
E502 – Vaginal birth after caesarean section (VBAC)
OHIP Surgical Assists Code — OBSTETRICS · Schedule of Benefits
The service for E502 covers a vaginal birth after a caesarean section (VBAC). This fee is applicable whether the attempt at vaginal delivery is successful or unsuccessful, meaning it is payable for a trial of labour after a previous caesarean section (TOLAC) that results in either a vaginal birth or a repeat caesarean section.
When to Use
- Bill E502 as an add-on to P006 or P020 when a patient with a prior caesarean section undergoes a trial of labour, regardless of whether the delivery concludes vaginally or via repeat caesarean section.
- Use this code when managing a TOLAC patient who requires an emergency or elective repeat caesarean section, as the fee is specifically intended to compensate for the increased complexity of the trial of labour.
Common Pitfalls
- Billing E502 as a standalone code; it must always be submitted in conjunction with a primary delivery code like P006, P020, or P018.
- Failing to include the code when a TOLAC results in a repeat caesarean section, mistakenly assuming the add-on only applies to successful vaginal births.
Billing Tips
- Ensure the primary delivery code (e.g., P006) is billed as the main service, with E502 appended to capture the specific complexity of the VBAC/TOLAC management.
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