E769 – Team fee for renal transplantation
OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This code represents a team fee that can be added to S435A (Kidney transplant). It is used in lieu of billing for a surgical assistant. Payment for E769 is not allowed when assistant fees (e.g., S435B) are billed for the same procedure. As per the general note for Renal Transplantation Procedures on page , claims for this service must be submitted on the recipient's claim. This fee does not include immunosuppressive therapy, which is billed on a fee-for-service basis.
When to Use
- Use E769 when the surgical team requires a collective fee for a kidney transplant (S435A) and you are opting out of billing individual surgical assistant fees.
- Apply this code specifically when the transplant team structure precludes the use of standard assistant billing (S435B) for the procedure.
Common Pitfalls
- Submitting E769 on the donor's claim instead of the recipient's claim will result in an automatic rejection.
- Billing E769 in conjunction with S435B is a direct violation of the Schedule of Benefits and will trigger a recovery audit.
Billing Tips
- Ensure E769 is attached exclusively to the recipient's claim to comply with the T3 section requirements for renal transplantation.
Effective: April 1, 2025
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Other
Urogenital and Urinary Surgical Procedures
Must be submitted on the recipient's claim.
Submit on recipient's claim. These fees do not include immunosuppressive therapy which is on a fee-for-service basis.
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