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E690
E690 – Oesophagoscopy - removal of foreign body(ies)
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable in addition to the fee for oesophagoscopy-gastroscopy, with or without duodenoscopy (`Z399, Z400`). It covers the service of removing one or more foreign bodies from the upper gastrointestinal tract. The commentary on page clarifies this includes the removal of a stent.
When to Use
- Use E690 when performing an oesophagoscopy (Z399 or Z400) specifically to extract an impacted food bolus or ingested object.
- Use E690 when retrieving an esophageal stent that has migrated or requires planned removal during an endoscopic procedure.
- Use E690 for the removal of multiple foreign bodies during a single session, as the code covers the service regardless of the number of items retrieved.
Common Pitfalls
- Billing E690 as a standalone procedure; it is an add-on code and will be rejected if not submitted with a primary oesophagoscopy code like Z399 or Z400.
- Confusing E690 with E692 (oesophageal dilation); ensure the procedure note clearly describes the mechanical removal of an object rather than stricture management.
- Failing to document the specific nature of the foreign body, which is essential for audit purposes to justify the additional procedural fee.
Billing Tips
- Ensure the primary procedure code (Z399 or Z400) is listed first on the claim to trigger the correct processing of the E690 add-on fee.
- If the procedure is performed after hours or on a weekend, apply the appropriate E409 or E410 premium to the total procedural fee, including the E690 component, provided the criteria for non-elective status are met.
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