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E760
E760 – Ureteroscopy with removal of calculus
OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable when a calculus (stone) is removed during a diagnostic ureteroscopy (Z628). It is added to the fee for the primary procedure.
When to Use
- Use E760 as an add-on to Z628 when a ureteral or renal calculus is successfully extracted during a diagnostic ureteroscopy.
- Apply this code when the primary intent of the procedure was diagnostic (Z628), but a stone was identified and removed during the same operative session.
Common Pitfalls
- Billing E760 without Z628 will result in an automatic rejection, as E760 is strictly an add-on code dependent on the primary diagnostic procedure.
- Do not bill E760 if the procedure is a formal ureterolithotomy or if a different primary surgical code (other than Z628) is used to describe the definitive stone management.
Billing Tips
- Ensure the operative report clearly documents the removal of the calculus to justify the add-on fee in the event of a post-payment audit.
- If the procedure qualifies for after-hours premiums (E409 or E410), apply the percentage increase to the combined value of the primary procedure and the E760 add-on.
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