E667 – Ruptured
OHIP Surgical Assists Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This is a premium code that is added to the fee for the repair or excision with graft of a ruptured thoracic aorta aneurysm (R799, R800, R801) or aortic arch reconstruction (R830, R831, R832). It is payable with the surgical codes for repair of the ascending aorta (R799), aortic arch (R800), or descending thoracic aorta (R801), or for aortic arch reconstruction (R830, R831, R832). Payment is conditional on the aneurysm being ruptured at the time of surgery.
When to Use
- Use E667 when performing an emergency open repair of a thoracic aortic aneurysm (R799, R800, or R801) where intraoperative findings confirm active rupture.
- Apply this premium when performing an aortic arch reconstruction (R830, R831, or R832) specifically necessitated by a ruptured aneurysm rather than an elective or symptomatic presentation.
Common Pitfalls
- Billing E667 for symptomatic or leaking aneurysms that have not progressed to a frank rupture, as this will trigger an audit rejection.
- Attempting to add age-based premiums from GP64 to the E667 fee itself, as the premium is strictly limited to the parent surgical procedure.
Billing Tips
- Ensure the operative report explicitly states 'ruptured' to satisfy the documentation requirement, as 'contained rupture' or 'leaking' may be interpreted differently by OHIP auditors.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Premium
Cardiovascular Surgical Procedures, Other Premiums (including After Hours Procedure Premiums)
The medical record must document that the thoracic aorta aneurysm was ruptured.
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