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E520
E520 – Excision of additional polyp (6 mm to 9 mm)
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable for the excision of each additional polyp measuring between 6 mm and 9 mm in size, performed during the same colonoscopy session. The fee for the primary polyp excision should be claimed using the appropriate 'Z' code corresponding to the size of the largest polyp removed (Z571, Z518, Z517, or Z516). This fee is claimed per additional polyp and is subject to usage limits.
When to Use
- Use E520 as an add-on code when you have already claimed the primary polyp excision using Z571, Z518, Z517, or Z516 and need to bill for a second polyp measuring 6-9 mm.
- Use this code when multiple polyps in the 6-9 mm range are removed during the same colonoscopy session, provided you do not exceed the combined daily limit of two additional polyp codes.
Common Pitfalls
- Claiming E520 without a primary Z-code (Z571, Z518, Z517, or Z516) will result in an automatic rejection.
- Exceeding the daily limit of two total services for the combined group of E720, E520, E519, and E518 will trigger a rejection for the excess services.
- Attempting to use E520 for polyps smaller than 6 mm or larger than 9 mm is a billing error; ensure the size corresponds strictly to the 6-9 mm range.
Billing Tips
- Always identify the largest polyp removed to establish the primary Z-code first, then append E520 for subsequent qualifying polyps.
- If you remove two polyps in the 6-9 mm range, claim the primary Z-code for the largest one and one unit of E520 for the second.
Provider Fee$77.50
Effective: April 1, 2025
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Digestive System Surgical Procedures
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