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E642
E642 – External approach nasal tip skin flap elevation
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
- if performed by external approach using transverse columellar and rim incisions with elevation of nasal tip skin flap, to M012, M013 or M014; - if performed by external approach using transverse columellar and rim incisions with elevation of nasal tip skin flap, to M015 or M016; - if performed by external approach using transverse columellar and rim incisions with elevation of nasal tip skin flap, to M030, M032 or M031
When to Use
- Use E642 as an add-on code specifically when performing an open rhinoplasty approach (transverse columellar and rim incisions) to facilitate the primary procedures M012, M013, or M014.
- Use E642 when the surgical plan requires full elevation of the nasal tip skin flap to access the cartilaginous framework for procedures coded under M015 or M016.
- Use E642 in conjunction with M030, M031, or M032 when an external approach is necessary to perform complex nasal tip reconstruction or septorhinoplasty.
Common Pitfalls
- Billing E642 as a standalone procedure; it is an add-on code and will be rejected if not submitted with a corresponding primary nasal surgical code.
- Attempting to bill E642 for endonasal (closed) approaches, which do not involve the required transverse columellar and rim incisions.
- Failure to link the E642 service to the primary procedure code on the same claim, which often triggers an automatic rejection for missing primary service.
Billing Tips
- Ensure the primary procedure (e.g., M012) and E642 are submitted on the same claim to satisfy the dependency requirement.
- If the procedure is non-elective and performed after hours, apply the E409 or E410 premium to the total fee, including the E642 component.
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