E591 – Osteotomy - phalanx - each additional
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is an add-on fee for performing an additional osteotomy on a phalanx. It is intended to be claimed for each additional unit of service beyond the primary procedure, `R258` (Osteotomy - middle proximal or metacarpal), when multiple osteotomies are performed in the same operative session. As a surgical procedure, it includes all common and specific elements applicable to surgery, such as preparation, performance of the procedure, and immediate post-operative care as detailed in the General Preamble (see pages , , ).
When to Use
- Use E591 for each additional phalanx osteotomy performed beyond the primary osteotomy billed under R258 during the same operative session.
- Apply this code when performing multi-level osteotomies on the same digit or across multiple digits if the primary procedure R258 has already been claimed for the initial osteotomy.
Common Pitfalls
- Billing E591 as a standalone procedure without an accompanying R258 will result in an automatic rejection.
- Attempting to use E591 for the primary osteotomy instead of R258 is a common error that leads to payment discrepancies.
- Failing to document the specific anatomical location of each additional osteotomy can lead to audit scrutiny regarding the necessity of multiple procedures.
Billing Tips
- Ensure the primary procedure R258 is billed first, followed by the appropriate number of units for E591 to reflect the total number of additional osteotomies performed.
- If performing multiple osteotomies on different digits, ensure your operative report clearly delineates each site to justify the use of multiple E591 units.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Procedure
Musculoskeletal System Surgical Procedures
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