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E693
E693 – Laparotomy with repair of ruptured bladder
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code is to be claimed in addition to laparotomy for acute trauma (S321) when a repair of a ruptured bladder is also performed during the same operative session. The amount payable for the surgeon's service (-A suffix) is determined by Independent Consideration (IC) by a Ministry of Health medical consultant and requires submission of a report. The surgical assistant's service (-B suffix) is valued at 4 basic units plus applicable time units.
When to Use
- Use E693 as an add-on code specifically when a bladder rupture is identified and repaired during a laparotomy performed for acute trauma (S321).
- Claim this code when the bladder repair is a distinct, secondary procedure necessitated by the trauma, rather than a routine component of the primary laparotomy.
Common Pitfalls
- Submitting the claim without a detailed operative report and a letter of justification will result in an automatic rejection or delay, as the fee is subject to Independent Consideration (IC).
- Attempting to claim E693 as a standalone procedure; it must be billed in conjunction with the primary trauma laparotomy (S321) to be valid.
- Failing to provide a comparative analysis of the procedure's complexity against non-IC codes, which is a mandatory requirement for the Ministry to determine the IC value.
Billing Tips
- Ensure the operative report explicitly details the extent of the bladder injury and the specific technique used for repair to support the requested IC fee.
- When billing the surgical assistant (-B suffix), remember that the 4 basic units are eligible for applicable age-based premiums and trauma premiums (E420) if the ISS criteria are met.
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