E798 – Management of complicated upper gastrointestinal bleeding in haemodynamically unstable patients
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on service for the management of complicated upper gastrointestinal bleeding by any technique (e.g. laser, injection, diathermy, banding etc.) in haemodynamically unstable patients with active bleeding observed during endoscopy. This service is claimed in addition to the primary endoscopy procedure.
When to Use
- Use E798 only when the patient meets the clinical definition of haemodynamic instability (e.g., hypotension, tachycardia) at the time of the procedure.
- Apply this code as an add-on to the primary endoscopic procedure (e.g., Z400) when active bleeding is visualized and requires therapeutic intervention like banding or injection.
Common Pitfalls
- Claiming E798 for routine endoscopic procedures where the patient is haemodynamically stable, which will result in audit recovery.
- Failing to explicitly document the patient's haemodynamic status and the presence of active bleeding in the procedure note, which is the primary requirement for this add-on.
- Attempting to bill E798 as a standalone code; it must be submitted in conjunction with the primary endoscopic procedure code.
Billing Tips
- Ensure the primary procedure code (e.g., Z400) is submitted on the same claim to avoid automatic rejection of the E798 add-on.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Procedure
Digestive System Surgical Procedures
The medical record must document that the patient is haemodynamically unstable.
The medical record must document active bleeding during endoscopy.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.