All codes
E553
E553 – Banked bone or bone substitutes
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Under the "BONE/FASCIAL/DERMIS GRAFTS" section for homogenous grafts, E553 is an add-on fee for the use of banked bone or bone substitutes. This fee is added to the main surgical procedure fee when these materials are utilized.
When to Use
- Use E553 when performing an orthopedic procedure that requires the application of allograft bone chips or synthetic bone substitutes to facilitate fusion or defect filling.
- Apply this code as an add-on to the primary surgical procedure code, such as those found in the musculoskeletal section, when the cost of the banked material is not already bundled into the primary fee.
Common Pitfalls
- Do not bill E553 if the primary surgical code description already explicitly includes the cost or use of graft materials, as this will trigger a duplicate payment rejection.
- Avoid billing E553 for autograft procedures, as this code is strictly reserved for banked (homogenous) bone or synthetic substitutes, not the patient's own harvested bone.
Billing Tips
- Ensure the operative report clearly documents the specific type and volume of the banked bone or substitute used to justify the add-on fee during a potential audit.
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