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E532
E532 – Both tibial plateaus, same knee
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Add 50% for both tibial plateaus, same knee, when performed in conjunction with a base procedure for medial or lateral tibial plateau fracture reduction, such as F081.
When to Use
- Use E532 as a 50% premium addition when you perform a formal open reduction and internal fixation (ORIF) on both the medial and lateral tibial plateaus during the same surgical session.
- Apply this code specifically when the base procedure (e.g., F081) was billed for a single plateau fracture, and the surgical report confirms that both plateaus required reduction and fixation.
Common Pitfalls
- Billing E532 without a corresponding base procedure code like F081 will result in an automatic rejection.
- Attempting to bill E532 for bilateral knees is incorrect, as the code is strictly defined for both plateaus within the same knee joint.
Billing Tips
- Ensure your operative report explicitly describes the reduction and fixation of both the medial and lateral tibial plateaus to justify the 50% surcharge during an audit.
Provider Fee$0.01
Effective: July 1, 2013
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Other
Code Classes
Musculoskeletal System Surgical Procedures
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