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E616

E616Bi-lobectomy on right side or segmentectomy plus lobectomy

OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

An additional fee that may be claimed for a bi-lobectomy on the right side when performed with a primary lung excision procedure, such as those listed with M-prefix codes. This fee is added to the value of the main surgical procedure.

When to Use

  • Claim this code as an add-on when performing a right-sided bi-lobectomy in conjunction with a primary lung excision procedure (e.g., M-prefix codes).
  • Use this code specifically for a segmentectomy performed in addition to a lobectomy to account for the increased complexity of the multi-lobe resection.

Common Pitfalls

  • Attempting to bill E616 as a standalone procedure; it must be linked to a primary M-prefix lung excision code to avoid automatic rejection.
  • Failing to apply the 85% multiple procedure rule when E616 is billed alongside other surgical procedures performed under the same anesthesia.

Billing Tips

  • Ensure the primary M-prefix code is listed first on the claim, followed by E616, to maintain proper hierarchy for the 85% payment adjustment rule.
Provider Fee$305.50

Effective: April 1, 2026

Category

P. Respiratory Surgical Procedures

Subcategory

RESPIRATORY SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Respiratory Surgical Procedures

The following E codes may apply to the preceding M prefix excision codes: E612, E613, E614, E615, E611, E849, E848, E616, E617, E618, E619, E620, E621, E624, E625, E608, E607.

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