E857 – D&C with laparoscopy
OHIP Surgical Assists Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on code payable in addition to another procedure. It applies when a Dilatation and Curettage (D&C) is medically required for abnormal uterine bleeding and is performed at the same time as either a tubal occlusion or a diagnostic laparoscopy. A D&C performed routinely with tubal occlusion without the specific indication of abnormal uterine bleeding is not eligible for payment.
When to Use
- Use E857 when performing a diagnostic laparoscopy for pelvic pain or infertility where a concurrent D&C is medically necessary to investigate abnormal uterine bleeding.
- Use E857 when performing a tubal occlusion (S741) if the patient has a documented history of abnormal uterine bleeding requiring endometrial sampling.
Common Pitfalls
- Billing E857 with a tubal occlusion (S741) without clear documentation of abnormal uterine bleeding will lead to audit recovery, as routine D&C with sterilization is explicitly non-eligible.
- Attempting to bill E857 alongside S784 (management of ectopic pregnancy or hysterectomy) will result in an automatic rejection due to the restricted code interaction.
Billing Tips
- Ensure the operative report explicitly states the indication for the D&C as 'abnormal uterine bleeding' to satisfy the specific requirement for this add-on code.
- If the procedure is performed after hours, remember that E857 is eligible for the E409 or E410 procedural premiums if the primary procedure also qualifies.
Effective: April 1, 2025
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
Procedure
Female Genital Surgical Procedures
Female
if a D&C is required for abnormal uterine bleeding and rendered with tubal occlusion or with diagnostic laparoscopy, to other procedure
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