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E624
E624 – Completion pneumonectomy for positive resection margin
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable in addition to an M-prefix lung excision procedure. This fee applies when a completion pneumonectomy is required due to a positive resection margin found during the initial surgery. This is considered an additional procedure and its payment is subject to the rules for multiple procedures as outlined in the Surgical Preamble (, ).
When to Use
- Use E624 when a frozen section confirms a positive margin during an M143 lobectomy, necessitating an immediate conversion to a completion pneumonectomy.
- Apply this code when a segmental resection (M144) is upgraded to a pneumonectomy due to intraoperative findings of positive margins requiring further excision.
Common Pitfalls
- Billing E624 as a standalone procedure; it must be linked to an M-prefix lung excision code to avoid automatic rejection.
- Failing to document the specific intraoperative finding of a positive resection margin, which is the mandatory clinical justification for this add-on fee during an audit.
Billing Tips
- Ensure the primary M-prefix procedure is billed at 100% and E624 is appended as an additional procedure, noting that it is specifically designed to compensate for the increased complexity of the completion surgery.
Provider Fee$111.20
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Respiratory Surgical Procedures
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