E554 – Synovectomy requiring a minimum of 30 minutes to resect
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
E554 is an add-on fee for a synovectomy when performed in conjunction with a primary surgical procedure from a specified list (see Related Codes). To be eligible for payment, the synovectomy must require a minimum of 30 minutes to resect. This fee is added to the fee for the primary procedure (e.g., `R236, R240, R436`, etc.). Per the note on , synovectomies performed with other reconstruction or arthroplasty procedures not on this list may be subject to assessment by a Medical Consultant.
When to Use
- Use E554 when performing a synovectomy that requires at least 30 minutes of resection time in addition to a primary procedure like R236 or R436.
- Use E554 for extensive synovial excision during joint reconstruction where the complexity of the disease process necessitates significant additional operative time.
Common Pitfalls
- Failing to explicitly document the start and end times for the synovectomy portion of the procedure, which is a mandatory requirement for audit compliance under GP7.
- Billing E554 alongside other synovectomy codes for the same joint in the same session, which will trigger an automatic rejection or adjustment.
- Assuming E554 is payable with any reconstruction; if the primary procedure is not on the approved list, the claim will be held for manual review by a Medical Consultant.
Billing Tips
- Ensure your operative report contains a distinct time-stamped entry for the synovectomy resection to satisfy the 'minimum 30 minutes' requirement for this add-on code.
- Always link E554 to the primary surgical procedure on the same claim to ensure the system recognizes it as an add-on, rather than a standalone service.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Procedure
Musculoskeletal System Surgical Procedures
The medical record must document that the synovectomy required a minimum of 30 minutes for the resection. In accordance with time-based service rules on , this requires recording the start and end times of the procedure in the patient's permanent medical record.
Reconstruction or Arthroplasty Procedures: If other procedures are claimed, same joint, same time, e.g. debridement, synovectomy, tendon release etc., the Medical Consultant will assess the surgeon's claim.
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