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E823
E823 – Resection and fulgarization of one or more ureteral or renal pelvic tumours
OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E823 as an add-on to Z628 when performing active resection and fulguration of identified ureteral or renal pelvic tumours.
- Use this code when the primary procedure is a diagnostic ureteroscopy (Z628) that transitions into a therapeutic intervention for tumour removal.
Common Pitfalls
- Billing E823 without Z628 on the same claim will result in an automatic rejection as it is strictly an add-on procedure.
- Attempting to bill Z638 in conjunction with Z628 and E823 is prohibited and will lead to claim adjustments or rejections.
- Failing to clearly document the specific location and nature of the tumour in the operative report increases audit risk for this add-on fee.
Billing Tips
- Ensure the claim includes both Z628 and E823 to trigger the full procedural payment; E823 is not a standalone code.
- Verify that the operative report explicitly describes the resection and fulguration technique to justify the E823 add-on beyond the base diagnostic Z628.
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