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E550
E550 – Insertion of closed irrigation system
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
An additional fee of $63.15 is payable for the insertion of a closed irrigation system during a surgical procedure for the purpose of post-operative management. This is billed in addition to the primary surgical procedure fee.
When to Use
- Use E550 when you explicitly insert a closed irrigation system (e.g., for continuous antibiotic or saline lavage) during a primary musculoskeletal surgery.
- Apply this code when the irrigation system is intended for post-operative management, such as in cases of deep infection or complex wound debridement.
Common Pitfalls
- Do not bill E550 for routine intra-operative wound lavage or simple drain placement, as these are considered integral to the primary surgical procedure.
- Avoid billing E550 if the irrigation system is not a 'closed' system; standard open-drain systems do not meet the criteria for this add-on fee.
- Ensure the primary surgical procedure is billed on the same claim, as E550 is an add-on code and will be rejected if submitted as a stand-alone service.
Billing Tips
- Document the specific type of closed irrigation system used and the clinical rationale for post-operative management to support the claim during an audit.
- If the procedure is performed after hours, ensure you apply the appropriate premium (e.g., E409 or E410) to the primary procedure, as E550 is eligible for these percentage-based increases.
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