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E803
E803 – Dilation of stricture
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E803 when a stricture is encountered and dilated during an endoscopic ultrasound procedure billed as S236 or S237.
- Apply this code when the dilation is necessary to allow the echo-endoscope to pass or to facilitate the primary diagnostic or therapeutic goal of the S236/S237 procedure.
Common Pitfalls
- Billing E803 as a standalone procedure is a common error; it must be linked to the primary S236 or S237 claim.
- Attempting to bill E803 alongside standard upper GI endoscopy codes without clear documentation of the necessity for the echo-endoscope procedure will lead to automatic rejection.
- Failure to document the specific location and nature of the stricture, which is required to justify the additional procedural fee.
Billing Tips
- Ensure E803 is submitted on the same claim as the primary S236 or S237 to avoid processing delays or denials.
- If the dilation is performed in an after-hours setting, ensure the relevant time-based premium (E409 or E410) is applied to the base procedure and the add-on code to maximize the claim value.
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