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E749

E749Private office premium for specified procedures

OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Premium added when Z491, Z492, Z493, Z494, Z495, Z496, Z497, Z498, Z499, Z512, Z555 or Z580 are rendered in a private office.

When to Use

  • Use E749 when performing a flexible sigmoidoscopy (Z512) in a private office setting rather than a hospital endoscopy suite.
  • Apply this premium when conducting a diagnostic or therapeutic procedure such as a Z491 (polypectomy) specifically within your private office facility.

Common Pitfalls

  • Billing E749 for procedures performed in a hospital or clinic that is part of a hospital facility will result in automatic rejection.
  • Attempting to bill E749 as a standalone service without an accompanying primary procedure code from the Z491-Z580 list will trigger a claim error.

Billing Tips

  • Ensure the procedure code (e.g., Z512) and the E749 premium are submitted on the same claim to ensure the premium is correctly linked to the eligible service.
Provider Fee$22.35

Effective: April 1, 2025

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Premium

Code Classes

Other Premiums (including After Hours Procedure Premiums)

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