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E816

E816ERCP with electrohydraulic lithotripsy for choledocholithiasis

OHIP Surgical Assists Code · Schedule of Benefits

Endoscopic retrograde cholangiopancreatography (ERCP) with electrohydraulic lithotripsy for choledocholithiasis

When to Use

  • Use E816 when a large or impacted bile duct stone cannot be cleared using standard balloon or basket extraction during an ERCP procedure coded as Z558.
  • Apply this code when electrohydraulic lithotripsy is specifically required to fragment a stone that has proven refractory to mechanical lithotripsy or standard extraction attempts.

Common Pitfalls

  • Billing E816 without a corresponding primary ERCP code like Z558 or Z561 will result in an automatic rejection.
  • Submitting E816 for routine stone extraction where standard mechanical methods were not first attempted or documented as failed is a common audit trigger.

Billing Tips

  • Ensure your operative report explicitly documents the failure of standard extraction techniques to justify the medical necessity of the electrohydraulic lithotripsy add-on.
Provider Fee$50.00

Effective: April 1, 2026

Service Type

Surgical Procedure (Add-on)

Code Classes

Procedure

E816 is only eligible for payment for confirmed choledocholithiasis that is refractory to standard extraction methods.

E816 is one of several add-on codes (including E662, E666, E668, E702, E680, E681, E669) that are payable with the primary ERCP codes Z561, Z558, or Z760.

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