E586 – Amputation with immediate fitting
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Amputation with immediate fitting to include supervision of final limb fitting, add 40% (E586). This premium is applied to the fee for the primary amputation procedure.
When to Use
- Use E586 when performing a major amputation (e.g., S865 or S866) where a prosthetic device is applied in the operating room immediately following the surgical closure.
- Apply this premium when the surgeon is actively involved in the supervision and coordination of the immediate post-operative prosthetic fitting process.
Common Pitfalls
- Billing E586 without a valid primary amputation code (e.g., S865, S866, S867) will result in an automatic rejection.
- Attempting to claim E586 for delayed prosthetic fittings performed weeks or months later is an audit risk, as it is strictly intended for immediate intra-operative or peri-operative fitting.
Billing Tips
- Ensure the primary amputation code is billed on the same claim as E586 to trigger the 40% calculation correctly.
Percentage Premium: 0.4%
This code applies a percentage increase to the base procedure fee
Effective: July 1, 2013
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
PercentageIncrease
Musculoskeletal System Surgical Procedures, Other Premiums (including After Hours Procedure Premiums)
Amputation with immediate fitting to include supervision of final limb fitting, add 40% (E586).
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