What is OHIP billing code E556?

E556 is "Extensive debridement of compound fractures or dislocations", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E556 pay?

E556 is a percentage premium: it adds 50% to the fee of the eligible service it is billed with, per the Ontario Schedule of Benefits.

How do I bill E556 to OHIP?

E556 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E556 claims against the Schedule of Benefits rules before submission.

What codes are related to E556?

Codes related to E556 in the Schedule of Benefits include E550, E551, E552, Z279, E553, R200, E547, E555.

All codes

E556

E556 – Extensive debridement of compound fractures or dislocations

OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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A premium that adds 50% to the fee for a fracture or dislocation reduction when extensive debridement is required. This is applicable to compound fractures or dislocations. The premium is applied to the corresponding reduction fee for the fracture/dislocation being treated.

When to Use

Use E556 when performing a formal surgical debridement of a compound (open) fracture that requires significant excision of devitalized tissue or irrigation beyond standard wound cleansing.
Apply this code specifically when the debridement is performed in conjunction with the reduction of a compound fracture or dislocation to reflect the increased complexity of the procedure.

Common Pitfalls

Do not bill E556 for simple wound irrigation or superficial cleaning of an open fracture, as this is considered part of the base reduction fee.
Avoid using E556 if the procedure is not a compound fracture or dislocation, as it will be rejected for lack of clinical correlation with the primary procedure code.
Failure to document the extent of the debridement (e.g., excision of necrotic muscle or bone) is a frequent audit trigger for this premium.

Billing Tips

Ensure E556 is submitted on the same claim as the primary reduction code to ensure the 50% calculation is applied correctly to the base fee.
When billing after-hours (E409/E410), calculate the premiums sequentially or as defined by the Schedule, ensuring E556 is applied to the base procedural fee before other percentage premiums are calculated.

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Percentage Premium: 0.5%

This code applies a percentage increase to the base procedure fee

Provider Fee$0.01

Effective: July 1, 2013

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