E613 – Sleeve pneumonectomy
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
The fee for `E613` is payable in addition to the fee for a primary lung excision procedure when a sleeve pneumonectomy is also performed. This service is intended to be claimed with the preceding M-prefix excision codes as noted on page of the Schedule. General payment rules for multiple surgical procedures, as outlined in the Surgical Preamble, apply. See page for details.
When to Use
- Use E613 exclusively as an add-on code when performing a sleeve pneumonectomy in conjunction with a primary lung excision procedure.
- Apply this code when the surgical plan necessitates the resection of the lung and the airway reconstruction (sleeve) as a single operative event.
Common Pitfalls
- Billing E613 as a standalone procedure will result in rejection; it must always be linked to an eligible M-prefix lung excision code.
- Failure to apply the multiple procedure rule (85% for the secondary procedure) to the lower-valued code when performing multiple surgical procedures under the same anaesthesia.
Billing Tips
- Ensure the primary lung excision code is billed at 100% and E613 is billed as the secondary procedure at 85% to comply with the Surgical Preamble rules.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures, Other Premiums (including After Hours Procedure Premiums)
The following E codes may apply to the preceding M prefix excision codes.
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