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E527
E527 – Additional tissue expander, same incision
OHIP Surgical Assists Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code is payable in addition to the primary procedure, `Z132` (Insertion of tissue expander), when an additional expander is placed through the same incision. This service is part of Plastic Surgery Procedures.
When to Use
- Use E527 when placing a second tissue expander during the same surgical session as the primary expander (Z132) through the identical incision site.
- Use this code for reconstructive procedures involving multiple expanders for scalp or body wall defects, provided the primary procedure Z132 is also billed.
Common Pitfalls
- Billing E527 for post-mastectomy breast reconstruction is strictly prohibited; it will be rejected as it is explicitly excluded for this indication.
- Attempting to bill E527 as a standalone procedure will result in rejection, as it must be linked to the primary Z132 claim.
- Failure to obtain the required pre-authorization (as per M24) for specific indications like leg scars will trigger an audit or claim rejection.
Billing Tips
- Ensure E527 is submitted on the same claim as Z132 to satisfy the requirement that it acts as an add-on to the primary procedure.
Provider Fee$58.95
Effective: April 1, 2025
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Integumentary System Surgical Procedures
Pre-Authorization Required
Authorization may be required from the Ministry of Health (e.g. for scars of legs, etc.).
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