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E623
E623 – Repeat operation after 30 days
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee, payable in addition to the primary procedure fee, for a repeat operation on the trachea or bronchi performed more than 30 days after the initial surgery. This is contextually applicable to excision procedures such as M099 (segmental resection of cervical trachea), M103 (segmental resection of trachea with either sternotomy or thoracotomy), and M104 (carinal resection).
When to Use
- Use E623 when performing a secondary segmental tracheal resection (M099, M103, or M104) on a patient who previously underwent the same procedure more than 30 days prior.
- Apply this code for re-interventions necessitated by late-onset complications, such as recurrent stenosis or granulation tissue, provided the 30-day threshold from the index surgery has passed.
Common Pitfalls
- Billing E623 for procedures performed within 30 days of the initial surgery will result in an automatic rejection, as these are considered part of the global surgical period.
- Attempting to claim E623 for non-tracheal or non-bronchial procedures is a common audit trigger, as the code is strictly limited to the specific respiratory procedures listed in the Schedule of Benefits.
Billing Tips
- Ensure the operative report clearly references the date of the initial procedure to justify the 'repeat' status and satisfy the 30-day requirement during a post-payment audit.
- Since E623 is an add-on fee, it should be submitted on the same claim as the primary procedure code (e.g., M103) to ensure the system correctly links the premium to the eligible surgical service.
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