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E597
E597 – Composite repair for facial paralysis - with meloplasty
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents an additional amount payable when a meloplasty is performed in conjunction with `R533 - Composite repair for facial paralysis, plication of paralyzed muscles, and resection for paralysis of over active muscles. This fee is added to the fee for R533. The parent procedure, R533`, is subject to assessment by a Medical Consultant.
When to Use
- Use E597 only when performing a meloplasty as a secondary component during the same operative session as the primary R533 composite repair for facial paralysis.
- Apply this code when the surgical plan explicitly includes both the muscle plication/resection (R533) and the additional meloplasty to address facial contour or soft tissue laxity.
Common Pitfalls
- Billing E597 as a standalone procedure will result in automatic rejection, as it is strictly an add-on code dependent on the approval of R533.
- Failing to provide sufficient operative detail for the R533 parent procedure often leads to a Medical Consultant rejection, which subsequently invalidates the E597 claim.
Billing Tips
- Ensure the operative report clearly distinguishes the meloplasty steps from the R533 muscle work to satisfy the Medical Consultant's assessment of the parent procedure.
Provider Fee$87.05
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Musculoskeletal System Surgical Procedures
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