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E805
E805 – Drainage of pseudocyst
OHIP Surgical Assists Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on code for the drainage of a pseudocyst performed during an endoscopic ultrasound procedure using a linear or radial echo-endoscope (e.g., `S236, S237`). The service includes stent insertion if performed as part of the drainage procedure. This fee is payable in addition to the fee for the primary endoscopic ultrasound procedure.
When to Use
- Use E805 when performing the drainage of a pancreatic pseudocyst via a linear or radial echo-endoscope during an EUS procedure coded as S236 or S237.
- Use E805 to capture the work of stent insertion when that stent is placed specifically to facilitate the drainage of the pseudocyst during the same EUS session.
Common Pitfalls
- Billing E805 as a standalone code will result in an automatic rejection; it must be submitted on the same claim as the primary S236 or S237 procedure.
- Attempting to bill E805 for routine diagnostic EUS procedures that do not involve active pseudocyst drainage will lead to audit recovery.
Billing Tips
- Ensure the primary procedure (S236 or S237) is listed first on the claim to establish the clinical context for the add-on E805 fee.
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