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E609
E609 – Closure of broncho-pleural fistula with intercostal muscle bundle, pericardium, Azygos vein, or pericardial fat pad
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This code is a premium service, billed in addition to the fee for a primary surgical procedure. It applies when reinforcement with an intercostal muscle bundle, pericardium, Azygos vein, or pericardial fat pad is required during a M130 (closure of broncho-pleural fistula) or M142 (pneumonectomy) procedure.
When to Use
- Use E609 when performing a formal closure of a broncho-pleural fistula (M130) that necessitates the use of an intercostal muscle flap or pericardial fat pad for reinforcement.
- Apply E609 as an add-on during a pneumonectomy (M142) when the surgeon specifically utilizes an Azygos vein or pericardial patch to buttress the bronchial stump.
Common Pitfalls
- Billing E609 as a standalone procedure will result in rejection; it must always be submitted alongside the primary M130 or M142 code.
- Attempting to bill E609 for simple primary closure without the specified reinforcement materials (intercostal muscle, pericardium, Azygos vein, or fat pad) is an audit risk for upcoding.
Billing Tips
- Ensure the operative report explicitly names the specific reinforcement tissue used, as this is the primary documentation required to justify the E609 premium during an audit.
Provider Fee$121.70
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Respiratory Surgical Procedures
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