E845 – 3D CT/MRI image guided system
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Payable in addition to the fee for M050, M052, M083 (Intranasal ethmoidectomy including maxillary antrostomy) or Z350 (Endoscopic sphenoidotomy) when the procedure is performed using a 3D CT/MRI image-guided system. This premium is only eligible for payment under specific circumstances, such as when the paranasal sinus anatomy is distorted or a lesion is near critical structures like the skull base, orbit, optic nerve, or carotid artery.
When to Use
- Use E845 when performing an endoscopic sphenoidotomy (Z350) or intranasal ethmoidectomy (M050, M052, M083) where the patient has significant anatomical distortion from prior trauma or previous sinus surgery.
- Use E845 when the surgical target is a lesion directly abutting high-risk structures such as the skull base, orbit, optic nerve, or carotid artery, necessitating image guidance for safety.
Common Pitfalls
- Billing E845 for routine endoscopic sinus surgery without documenting the specific anatomical distortion or proximity to critical structures as required by the Schedule of Benefits.
- Attempting to claim E845 with surgical codes outside the explicitly defined list (M050, M052, M083, or Z350), which will result in automatic rejection.
Billing Tips
- Ensure your operative report explicitly describes the anatomical distortion or the specific relationship between the lesion and the critical structures to satisfy audit requirements for this premium.
- Submit E845 on the same claim as the primary procedure code (e.g., M083) to ensure the system correctly links the premium to the eligible base service.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Premium
Other Premiums (including After Hours Procedure Premiums), Respiratory Surgical Procedures
E845 is only eligible for payment under the following circumstances: 1. Identification of the anatomy of the paranasal sinuses distorted by previous surgery, trauma, abnormalities of development or benign or malignant tumours; or 2. A pathological lesion abuts the base of the skull, orbit, optic nerve or carotid artery.
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