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E898

E898Lesion greater than 2.5 cm

OHIP Surgical Assists Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits

- lesion greater than 2.5 cm, to N105 or N154

When to Use

  • Use E898 as an add-on code when the lesion size excised or treated via N105 (Excision of lesion of scalp) or N154 (Excision of lesion of skull) exceeds 2.5 cm in diameter.
  • Apply this code specifically when the surgical report explicitly documents the lesion measurement as greater than 2.5 cm to justify the additional complexity fee.

Common Pitfalls

  • Billing E898 without an associated primary procedure code (N105 or N154) will result in an automatic rejection.
  • Attempting to bill E898 for lesions 2.5 cm or smaller is a common audit trigger; the measurement must exceed the 2.5 cm threshold to qualify.
  • Failing to document the specific dimensions of the lesion in the operative note makes this code non-payable upon post-payment audit.

Billing Tips

  • Ensure the operative report clearly states the lesion size in centimeters, as 'large' or 'extensive' are insufficient descriptors for OHIP verification.
Provider Fee$283.80

Effective: April 1, 2025

Since Apr 2004, this fee has increased 23.6% vs 57.0% CPI inflation
Category

X. Neurological Surgical Procedures

Subcategory

NEUROLOGICAL SURGICAL PROCEDURES

Service Type

Other

Code Classes

Diagnostic and Therapeutic Procedures

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