E801 – Radial or linear probe through endoscope - including biliary and/or pancreatic examination
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee code represents an add-on service for endoscopic ultrasound performed with a radial or linear probe through an endoscope, which includes a specific examination of the biliary and/or pancreatic systems. This is intended to be added to the fee for the primary endoscopy service. Per the note on page , the amount payable for E800 (endoscopic ultrasound without biliary/pancreatic examination) is zero when rendered in conjunction with E801.
When to Use
- Use E801 when performing endoscopic ultrasound specifically targeting the biliary tree or pancreatic parenchyma, as this is the higher-value code for these anatomical areas.
- Use E801 as the primary procedural add-on when EUS is utilized to stage pancreatic malignancy or evaluate biliary obstruction, replacing the need for E800.
Common Pitfalls
- Billing E800 and E801 together will result in the rejection or zero-payment of E800, as E801 is intended to capture the more complex biliary/pancreatic examination.
- Failing to link the procedure to the appropriate primary endoscopy code can lead to audit flags regarding the necessity of the ultrasound component.
Billing Tips
- Ensure E801 is appended to the primary endoscopy fee; if the procedure is performed after hours, apply E409 or E410 to the total procedural fee to maximize the premium value.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Procedure
Digestive System Surgical Procedures, Diagnostic and Therapeutic Procedures
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