All codes
E612
E612 – Total extra-pleural pneumonectomy
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This code is an add-on payable in addition to the fee for the primary surgical procedure when a total extra-pleural pneumonectomy is performed. As per the P section of the Schedule of Benefits, this code applies to preceding M prefix excision codes.
When to Use
- Use E612 strictly as an add-on when performing a total extra-pleural pneumonectomy in conjunction with an M-prefix excision code for malignant pleural mesothelioma.
- Apply this code only when the surgical procedure involves the complete removal of the lung, parietal pleura, and pericardium/diaphragm as part of an extra-pleural approach.
Common Pitfalls
- Billing E612 without an accompanying M-prefix excision code will result in an automatic rejection as it is defined as an add-on procedure.
- Attempting to bill E612 for a standard pneumonectomy (which does not involve the extra-pleural dissection) is an audit risk and an incorrect use of the code.
Billing Tips
- Ensure the primary M-prefix excision code is listed first on the claim to establish the base procedure before adding E612.
- Verify that the operative report explicitly details the extra-pleural dissection, as this is the clinical requirement that differentiates E612 from standard pulmonary resection codes.
Provider Fee$338.35
Effective: April 1, 2025
Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Respiratory Surgical Procedures
Payable in addition to preceding M prefix excision codes.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.