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E513
E513 – Breast mound creation by soft tissue
OHIP Surgical Assists Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E513 when performing the specific shaping and insetting of a soft tissue flap as a secondary or component step in autogenous breast reconstruction.
- Use E513 in conjunction with the primary flap harvest and transfer codes (R118, R125, R064, R008, or R155) to account for the distinct work of mound creation and contouring.
Common Pitfalls
- Attempting to bill E513 alongside E529 will result in an automatic rejection, as these codes are mutually exclusive for the same operative session.
- Billing E513 as a standalone procedure without an associated primary flap code (R118, R125, R064, R008, or R155) may trigger an audit for unbundling or invalid procedural reporting.
Billing Tips
- Ensure the operative report clearly distinguishes the flap harvest/transfer from the specific mound creation and insetting steps to justify the use of E513 as an additional procedural component.
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