E720 – Excision of additional polyp (3 mm to 5 mm)
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code is an add-on fee for the excision of each additional intestinal polyp with a size of 3mm to 5mm. It is intended to be claimed in conjunction with a primary polyp excision code (Z571, Z518, Z517, or Z516), which is determined by the size of the largest polyp removed. A maximum of two services from the add-on polyp excision codes (E720, E520, E519, or E518) are payable per patient per day. Excision of polyps smaller than 3mm is not eligible for payment.
When to Use
- Use E720 as an add-on when you have already billed a primary excision code (Z571, Z518, Z517, or Z516) for the largest polyp and have removed at least one additional polyp measuring 3mm to 5mm.
- Use E720 for the second additional polyp in the 3mm to 5mm range, as the OHIP schedule allows for a maximum of two add-on services per patient per day.
Common Pitfalls
- Billing E720 for polyps smaller than 3mm, which are considered part of the primary procedure and are not eligible for additional payment.
- Exceeding the maximum of two add-on services per patient per day; any additional polyps beyond the second add-on are not separately billable.
- Failing to link E720 to a valid primary code (Z571, Z518, Z517, or Z516); the add-on will be rejected if the primary code is missing or invalid.
Billing Tips
- Ensure your documentation clearly records the size of each polyp removed to justify the use of E720 versus other add-on codes like E520, E519, or E518.
- Always identify the largest polyp first to select the correct primary code (Z571-Z516), as this determines the base fee before adding E720 for subsequent smaller polyps.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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