E695 – Laser palliation of oesophageal tumour, extensive, complete obstruction
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
An add-on fee to oesophagoscopy-gastroscopy, with or without duodenoscopy (`Z399 or Z400`), for the laser palliation of an extensive, completely obstructing oesophageal tumour. The fee for this service is determined by Independent Consideration (IC) by a medical consultant. Claims for E695 must be submitted with a supporting letter explaining the amount of the fee claimed, an appropriate operative report, and a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule. See for details on IC.
When to Use
- Use E695 when performing laser recanalization for a patient with a high-grade or complete esophageal obstruction that prevents the passage of a standard endoscope.
- Select this code when the procedure involves extensive laser ablation of tumor bulk to restore luminal patency, distinguishing it from simple diagnostic biopsies or minor lesion removals.
Common Pitfalls
- Failing to provide a detailed operative report that explicitly describes the 'extensive' nature of the obstruction and the specific laser technique used, which often leads to automatic rejection of the IC claim.
- Submitting the claim without a comparative analysis against non-IC procedures like Z399 or Z400, which is a mandatory requirement for the Ministry to evaluate the requested fee.
Billing Tips
- When justifying the IC fee, benchmark the time and technical complexity against the fixed fees for Z399 or Z400 to provide the medical consultant with a clear frame of reference for the additional work performed.
No fee information available.
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Procedure
Digestive System Surgical Procedures, Diagnostic and Therapeutic Procedures
Claims for services listed as Independent Consideration (IC) must be submitted with a supporting letter explaining the amount of the fee claimed.
Claims for IC services must include an appropriate operative or consultation report.
Claims for IC services must include a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule.
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