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E726
E726 – Repeat recurrent inguinal hernia (more than 2 repairs)
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is an add-on to a primary inguinal hernia repair procedure, payable when performing a repair for a repeat recurrent hernia, which is defined as a hernia that has recurred after two or more previous repairs. This code must be billed in addition to one of the following primary procedure codes: `S322, S323, S326, S329, or S330`.
When to Use
- Use this code when performing a third or subsequent inguinal hernia repair, specifically when the patient has a documented history of at least two prior repairs for the same hernia.
- Apply this code as a mandatory add-on when performing a complex recurrent repair using primary codes S322, S323, S326, S329, or S330.
Common Pitfalls
- Billing E726 as a standalone procedure will result in automatic rejection; it must always be linked to a primary inguinal hernia repair code on the same claim.
- Confusing E726 with E725; E726 is strictly reserved for patients undergoing their third or subsequent repair, whereas E725 is for the first recurrence.
- Failure to verify the patient's surgical history; billing E726 without clear documentation of two previous repairs in the chart is a significant audit risk.
Billing Tips
- Ensure the primary procedure code (S322, S323, S326, S329, or S330) is billed on the same claim to trigger the payment for the E726 add-on.
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