E792 – Laparoscopic approach premium
OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
`E792` is a percentage-based premium that adds 25% to the fee of an eligible primary surgical procedure when the surgery is performed laparoscopically. This premium applies to a specific list of procedures found in the 'Urogenital and Urinary Surgical Procedures' and 'Male Genital Surgical Procedures' sections of the Schedule of Benefits. Eligible primary codes include, but are not limited to: S403, S411, S422, S436, S482, S590, and S651.
When to Use
- Use E792 when performing a laparoscopic nephrectomy (S403) or laparoscopic pyeloplasty (S422) to claim the 25% premium on the primary surgical fee.
- Apply E792 when performing laparoscopic radical prostatectomy (S482) or laparoscopic cystectomy (S590) as these are specifically designated eligible procedures in the Schedule of Benefits.
Common Pitfalls
- Billing E792 with a surgical code that is not explicitly listed in the Schedule of Benefits as eligible for the laparoscopic premium will result in an automatic rejection.
- Attempting to claim E792 for procedures performed via open or robotic-assisted approaches, as the premium is strictly reserved for laparoscopic techniques.
- Failure to link E792 to the primary surgical code on the same claim submission can lead to the premium being processed incorrectly or denied.
Billing Tips
- Ensure E792 is submitted on the same claim as the primary surgical code; it is a percentage-based add-on that calculates automatically based on the primary fee.
- When performing multiple procedures, confirm that E792 is applied only to the primary eligible laparoscopic procedure, as it does not apply to secondary or incidental procedures performed during the same session.
Percentage Premium: 0.25%
This code applies a percentage increase to the base procedure fee
Effective: September 1, 2011
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
PercentageIncrease
Other Premiums (including After Hours Procedure Premiums)
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