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E848
E848 – Reconstruction of pericardium requiring repair with synthetic graft material
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable in addition to the primary procedure fee when reconstruction of the pericardium requires repair with synthetic graft material. This code is intended to be used with M-prefix lung and pleura excision codes as per the note on .
When to Use
- Use E848 when performing a pericardial reconstruction using synthetic graft material (e.g., Gore-Tex or Dacron) specifically during an M-prefix lung or pleura excision procedure.
- Use this code when the pericardial defect is significant enough to require a patch, distinguishing it from simple primary closure or pericardial debridement.
Common Pitfalls
- Billing E848 without an associated M-prefix lung or pleura excision code will result in an automatic rejection.
- Attempting to bill E848 for pericardial closure using native tissue or pericardial fat pads, as the code explicitly requires synthetic graft material.
- Failing to document the specific type of synthetic material used, which is a common trigger for post-payment audit reviews.
Billing Tips
- Ensure E848 is submitted on the same claim as the primary M-prefix procedure to avoid processing errors.
- Since E848 is an add-on code, it is exempt from the 85% multiple procedure reduction rule that applies to secondary surgical procedures.
Provider Fee$80.00
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Respiratory Surgical Procedures
The following E codes may apply to the preceding M prefix excision codes.
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