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E515

E515Incision of abscess or hematoma - sole procedure under general anaesthetic

OHIP Surgical Assists Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Incision of abscess or hematoma when performed as sole procedure under general anaesthetic in an operating room but not in an emergency department or emergency department equivalent . To Z102, Z172, Z105, Z107, Z541, Z574, Z758 .........................................................add 110%.

When to Use

  • Use E515 as a premium code when performing an I&D of a subcutaneous abscess (Z102) in a formal operating room setting under general anesthesia.
  • Apply E515 when the I&D of a perianal abscess (Z105) or ischiorectal abscess (Z107) is the sole procedure performed under general anesthesia.

Common Pitfalls

  • Billing E515 for procedures performed in an emergency department or minor procedure room will result in automatic rejection, as the code explicitly excludes these locations.
  • Attempting to claim E515 when other surgical procedures are performed during the same operative session will lead to audit flags, as it is strictly defined as a sole procedure code.

Billing Tips

  • Always pair E515 with the appropriate primary procedure code (e.g., Z102, Z105, Z107) to trigger the 110% premium payment correctly.
Provider Fee$0.01

Effective: April 1, 2020

Category

M. Integumentary System Surgical Procedures

Subcategory

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES

Service Type

Other

Code Classes

Diagnostic and Therapeutic Procedures, Integumentary System Surgical Procedures

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