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E604A
E604A – Fixation of Each Additional Rib Exceeding Four Ribs - Surgeon
OHIP Surgical Assists Code — Respiratory Surgical Procedures · Schedule of Benefits
Payable to the surgeon for the fixation of each additional rib exceeding four ribs. This is an add-on to a primary rib fixation procedure such as M116 (fixation for trauma). This code is claimed for each additional rib fixed.
When to Use
- Use E604A for the fifth, sixth, and seventh rib fixed during a single operative session where M116 was the primary procedure.
- Apply this code only when the total number of ribs surgically fixated exceeds four, with E604A representing each individual rib beyond that threshold.
Common Pitfalls
- Claiming E604A for the first four ribs, which are already included in the primary M116 fee; this will result in automatic rejection or audit recovery.
- Failing to clearly delineate the number of units claimed; each unit of E604A must correspond to one specific additional rib beyond the initial four.
- Confusing E604A with E604B or E604C, which are intended for different surgical contexts or specific anatomical rib fixation requirements.
Billing Tips
- Ensure the total count of ribs fixed is explicitly documented in the operative report to justify the number of E604A units submitted.
- When applying trauma premiums like E420, ensure the ISS score is documented in the chart, as E604A is eligible for the 50% trauma uplift when the criteria are met.
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