E863 – Laparoscopic premium for vaginal surgeon
OHIP Surgical Assists Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This code represents a 25% fee premium applicable to the vaginal surgeon's fee when a two-surgeon vaginal procedure is performed laparoscopically. This premium is added to the fee listed for the primary procedure codes: S730 (Primary approach), S732 (Following previous failed procedure), or S749 (Following two or more failed procedures).
When to Use
- Use E863 when you are the vaginal surgeon performing a laparoscopic-assisted procedure alongside an abdominal surgeon for S730, S732, or S749.
- Apply this premium specifically when the surgical approach requires laparoscopic assistance to facilitate the vaginal component of the procedure.
Common Pitfalls
- Billing E863 when you are the abdominal surgeon; the abdominal surgeon must use E862 instead.
- Applying the 25% premium to the total procedure fee rather than the vaginal surgeon's specific fee component, which can trigger audit flags.
- Submitting E863 without a corresponding primary procedure code from the S730, S732, or S749 set, leading to automatic rejection.
Billing Tips
- Ensure the claim clearly identifies the two-surgeon arrangement to justify the use of the premium alongside the primary S-code.
Percentage Premium: 0.25%
This code applies a percentage increase to the base procedure fee
Effective: September 1, 2011
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
PercentageIncrease
Female Genital Surgical Procedures, Other Premiums (including After Hours Procedure Premiums)
Payable as a 25% premium to the vaginal surgeon's fee when performed laparoscopically.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.