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E697
E697 – Gastrostomy - with repair of Mallory-Weiss laceration
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E697 exclusively as an add-on code when performing a surgical repair of a Mallory-Weiss tear during an open abdominal procedure, such as a gastrostomy (S118).
- It is the appropriate code for the surgical management of a persistent or severe Mallory-Weiss laceration that has failed endoscopic intervention and requires open surgical access.
Common Pitfalls
- Billing E697 as a standalone procedure will result in rejection, as it is strictly an add-on code intended to be billed alongside a primary surgical procedure.
- Failing to document the specific anatomical location and the necessity of the open surgical repair can lead to audit recovery, as endoscopic management is the standard of care for most Mallory-Weiss tears.
Billing Tips
- Ensure the primary procedure (e.g., S118) is billed as the main item on the claim to avoid rejection of the E697 add-on.
Provider Fee$142.40
Effective: April 1, 2025
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
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