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E585
E585 – Amputation - each additional
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service represents each additional metatarsal/phalanx disarticulation performed during the same operation as R620. It is an add-on code and is not intended to be billed as a standalone procedure.
When to Use
- Use E585 for each subsequent metatarsal or phalanx disarticulation performed beyond the first digit, which is billed under R620.
- Apply this code when performing multiple toe amputations during a single operative session to account for the additional surgical work.
Common Pitfalls
- Billing E585 as a standalone procedure will result in an automatic rejection, as it is strictly an add-on code requiring R620 on the same claim.
- Over-billing the number of units of E585 without clear documentation of the specific number of additional digits disarticulated is a frequent audit trigger.
Billing Tips
- Ensure the primary procedure R620 is listed first on the claim, followed by the appropriate number of units for E585 to reflect the total number of additional digits removed.
- If performing multiple amputations on different feet, ensure the claim reflects the correct site indicators to avoid confusion regarding the total count of 'additional' procedures.
Provider Fee$47.30
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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