E615 – Intra-pericardial dissection
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on code payable in addition to the fee for a primary excision procedure of the lung or pleura. It is intended for the work of performing an intra-pericardial dissection as part of the main surgery. According to the Schedule, `E615` 'may apply to the preceding M prefix excision codes' found in the Respiratory Surgical Procedures section.
When to Use
- Use E615 when performing an intra-pericardial dissection to facilitate a primary lung excision, such as a lobectomy (e.g., M156) or pneumonectomy (e.g., M157).
- Apply this code when the dissection is required to manage hilar structures that are otherwise inaccessible without opening the pericardial sac.
Common Pitfalls
- Billing E615 without a valid primary 'M' prefix excision code from the Respiratory Surgical Procedures section will result in an automatic rejection.
- Attempting to bill E615 for standard hilar dissection that does not involve entering the pericardial space constitutes an over-billing risk during audit.
- Do not confuse E615 with other add-on codes like E616 or E617; ensure the specific anatomical dissection performed matches the code definition.
Billing Tips
- Ensure the operative report explicitly documents the opening of the pericardium and the specific intra-pericardial dissection performed to support the add-on claim.
- Verify that the primary procedure code is one of the eligible 'M' prefix excision codes, as E615 is strictly restricted to these specific base procedures.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Procedure
Respiratory Surgical Procedures
This code is payable in addition to the fee for the primary procedure. The Schedule states: 'The following E codes may apply to the preceding M prefix excision codes ... E615: intra-pericardial dissection'.
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