E676B – Morbidly Obese Patient, Surgical Assistant, to Major Procedure Add - 6 Units
OHIP Surgical Assists Code — Surgical Preamble · Schedule of Benefits
E676B is a premium for a surgical assistant, adding 6 basic units to the fee for the major procedure. It is eligible for payment when a morbidly obese patient undergoes major surgery to the neck, thorax, peritoneal cavity, retroperitoneum, pelvis, or hip. Specific conditions must be met: - The patient must have a Body Mass Index (BMI) greater than 40 for major surgery on the thorax, peritoneal cavity, retroperitoneum, pelvis, or hip, or a BMI greater than 45 for major surgery on the neck. - The surgery must be rendered under general anaesthesia using either an open technique for the neck, thorax, or hip, or an open or laparoscopic technique for the peritoneal cavity, pelvis, retroperitoneum. - The principal surgical technique cannot be aspiration, core or fine needle biopsy, dilation, endoscopy, mediastinoscopy, thoracoscopy, cautery, ablation, or catheterization. - It is only payable with a specific list of major surgical procedures as detailed in the billing interactions.
When to Use
- Use when acting as a surgical assistant for an open procedure on the thorax, peritoneal cavity, retroperitoneum, pelvis, or hip where the patient's BMI is documented as greater than 40.
- Use when acting as a surgical assistant for an open neck procedure where the patient's BMI is documented as greater than 45.
- Use specifically for laparoscopic procedures in the peritoneal cavity, pelvis, or retroperitoneum provided the patient meets the BMI threshold of 40.
Common Pitfalls
- Billing E676B for procedures performed under local or regional anesthesia, as the code strictly requires general anesthesia.
- Attempting to claim this premium for procedures like endoscopy, biopsy, or cautery, which are explicitly excluded from eligibility regardless of patient BMI.
- Failing to document the patient's specific BMI in the medical record, which is the primary trigger for audit recovery.
Billing Tips
- Ensure the primary surgical procedure code submitted is on the approved list provided in the billing interactions, as the claim will automatically reject if the base procedure is not included.
- Always verify that the surgical technique used is 'open' for neck, thorax, or hip surgeries, as laparoscopic techniques are only permitted for abdominal, pelvic, or retroperitoneal procedures.
No fee information available.
Surgical Procedures
Surgical Preamble
Premium
Surgical Assistants' Services, Other Premiums (including After Hours Procedure Premiums)
The patient's Body Mass Index (BMI) must be recorded in the patient's permanent medical record.
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