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E723
E723 – Laparotomy with repair of lacerated spleen
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee code is for the surgical repair of a lacerated spleen. It is an add-on procedure and must be billed in conjunction with `S321` (Laparotomy for acute trauma). An assistant's service is payable, with 4 base units assigned as per the schedule. This service is eligible for various premiums, including after-hours, trauma, and age-based premiums for pediatric patients.
When to Use
- Use E723 specifically for the repair of a splenic laceration discovered during an exploratory laparotomy for trauma, ensuring it is billed alongside S321.
- Use this code when the surgical intervention is limited to the repair of the spleen itself, rather than a total or partial splenectomy (which would require different codes).
Common Pitfalls
- Failing to bill S321 (Laparotomy for acute trauma) on the same claim will result in an automatic rejection of E723.
- Attempting to claim E420 (Trauma premium) in addition to after-hours premiums (E409/E410) is a billing error, as these are mutually exclusive.
Billing Tips
- Always document the Injury Severity Score (ISS) in the patient record to justify the E420 trauma premium, as this is a mandatory audit requirement.
- Ensure that the start time of the procedure is clearly noted to correctly apply E409 or E410, which significantly increases the procedural fee.
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