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E505
E505 – Limited axillary node sampling
OHIP Surgical Assists Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
An add-on fee payable for performing a limited axillary node sampling. This service is claimed in addition to a primary breast procedure. It is applicable to the following services: Partial mastectomy or wedge resection (R111), Simple mastectomy (R108), Subcutaneous mastectomy with nipple preservation (R117), Mastectomy for pathological male breast disease - simple (R148) or subcutaneous (R149), and Oncoplastic breast conserving surgery - Level 1 (R102), Level 2 (R158), or Level 3 (R159).
When to Use
- Use E505 when performing a limited axillary node sampling in conjunction with a primary breast procedure like a partial mastectomy (R111) or simple mastectomy (R108).
- Apply this code when the clinical intent is a limited sampling of nodes rather than a formal sentinel node biopsy (Z427) or a full axillary lymph node dissection.
Common Pitfalls
- Do not bill E505 alongside Z427; the system will reject the claim as these are mutually exclusive procedures for nodal assessment.
- Ensure the primary procedure code (e.g., R102, R117, R158) is correctly linked on the same claim, as E505 is an add-on fee and cannot be billed as a standalone service.
Billing Tips
- Verify that the surgical report explicitly describes a 'limited sampling' to justify the use of E505 over other nodal assessment codes.
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