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E629

E629Endoscopic placement of stent in duodenum

OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

E629 is an add-on code for the endoscopic placement of a stent in the duodenum. It is claimed in addition to a primary endoscopic procedure such as oesophagoscopy-gastroscopy-duodenoscopy (e.g., `Z399, Z400) or duodenoscopy (Z560`).

When to Use

  • Use E629 when performing a palliative duodenal stent placement for malignant gastric outlet obstruction during an OGD (Z399 or Z400).
  • Use E629 when placing a stent to manage a benign duodenal stricture or fistula during a diagnostic duodenoscopy (Z560).

Common Pitfalls

  • Billing E629 as a standalone service will result in an automatic rejection; it must be submitted on the same claim as the primary endoscopic procedure.
  • Failing to link the stent placement to the primary procedure code can lead to audit flags if the primary procedure is not clearly identified as the base for the add-on.
  • Attempting to bill E629 for esophageal or colonic stenting, as this code is strictly restricted to duodenal placement.

Billing Tips

  • Ensure the primary procedure (e.g., Z399) is listed first on the claim, followed by E629, to ensure the system recognizes the add-on relationship.
  • If the procedure is performed after hours or for trauma, apply the relevant premiums (E409, E410, or E420) to the primary procedure fee, as E629 is an add-on that typically follows the base procedure's eligibility for these premiums.
Provider Fee$137.05

Effective: April 1, 2025

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Procedure

Code Classes

Digestive System Surgical Procedures

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