E854 – Ureterolysis - unilateral
OHIP Surgical Assists Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
ureterolysis - unilateral - payable in conjunction with major gynaecological operative procedure except S743 and must include surgical definition of pararectal and paravesical spaces, identification of uterine artery and vein, and mobilization of the pelvic ureter from common iliac vessels to ureterovesical junction
When to Use
- Use E854 when performing a radical hysterectomy or complex pelvic surgery where the ureter must be mobilized from the common iliac vessels down to the ureterovesical junction to ensure safe dissection.
- Use this code specifically for unilateral ureterolysis when the surgical steps include the mandatory definition of pararectal and paravesical spaces and identification of the uterine artery and vein.
Common Pitfalls
- Billing E854 in conjunction with S743 is strictly prohibited; the Ministry will reject the claim as these procedures are mutually exclusive.
- Failure to explicitly document the mobilization of the ureter from the common iliac vessels to the ureterovesical junction will lead to audit recovery, as this is a specific requirement defined in the Schedule of Benefits.
- Claiming E854 for simple ureteral identification without the required mobilization and space definition will result in a rejection or clawback upon review.
Billing Tips
- Ensure your operative report uses the exact terminology required by the Schedule (pararectal space, paravesical space, uterine artery/vein identification) to satisfy the specific documentation requirements for this code.
- Since E854 is a unilateral code, ensure the claim clearly specifies the side (left or right) to avoid processing errors or potential duplicate billing issues.
Effective: April 1, 2025
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
Surgical
Female Genital Surgical Procedures, Diagnostic and Therapeutic Procedures
Surgical definition of pararectal and paravesical spaces.
Identification of uterine artery and vein.
Mobilization of the pelvic ureter from common iliac vessels to ureterovesical junction.
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