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E757
E757 – Umbilical Hernia Repair - without Resection of Strangulated Contents (Add-On)
OHIP Surgical Assists Code — Digestive System · Schedule of Benefits
When to Use
- Use when performing an umbilical hernia repair (e.g., S332 or S333) where the hernia sac contains bowel or omentum that is incarcerated or strangulated but viable, requiring no resection.
- Use when the surgical note explicitly confirms the presence of strangulated contents that were successfully reduced without the need for bowel resection or enterotomy.
Common Pitfalls
- Billing E757 when the hernia is merely incarcerated but not strangulated, which may lead to audit recovery if the operative report does not support the clinical finding of strangulation.
- Billing E757 without a primary hernia repair code (S332 or S333), which will result in an automatic rejection as this is a strictly defined add-on code.
Billing Tips
- Ensure the operative report clearly documents the 'strangulated' status of the contents to justify the additional complexity and the use of this specific add-on fee.
- If resection of the strangulated contents is required, E757 is not the correct code; you must instead bill the appropriate primary procedure for the resection (e.g., S333 with bowel resection codes).
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