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E537
E537 – Tenolysis - each additional digit
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code is an add-on to R575 (Tenolysis - flexor and/or extensor tendon of one digit) and is payable for the tenolysis of each additional digit.
When to Use
- Use E537 only when performing a tenolysis on a second or subsequent digit during the same operative session as the primary procedure (R575).
- Apply E537 for each additional digit beyond the first, provided that each digit requires a distinct tenolysis procedure.
Common Pitfalls
- Billing E537 without a corresponding R575 on the same claim will result in an automatic rejection.
- Attempting to use E537 for multiple tendons within the same digit is incorrect; E537 is strictly per digit, not per tendon.
- Failing to clearly document the specific digits treated in the operative report often leads to audit adjustments if the number of units billed for E537 is questioned.
Billing Tips
- Ensure the primary procedure R575 is billed as the first line item, followed by E537 with the appropriate number of units for the additional digits treated.
- When applying after-hours premiums (E409/E410), ensure the percentage increase is calculated against the total fee of both R575 and the applicable units of E537.
Provider Fee$165.20
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Musculoskeletal System Surgical Procedures
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