E906 – Operating microscope add-on
OHIP Surgical Assists Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This is a premium that adds 40% to the basic fee for neurolysis, nerve tumour excision, nerve suture, nerve transfer, or nerve graft procedures when an operating microscope is used. This premium is applied to the surgical fee (-A suffix).
Applicable procedures include, but are not limited to:
- Neurolysis: e.g., N188, N285, N190, N189
- Nerve Tumour Excision: e.g., N286, N295
- Nerve Suture: e.g., N289, N287
- Nerve Transfer: e.g., N293, N291
When to Use
- Use E906 when performing microsurgical neurolysis (e.g., N188) or nerve suture (e.g., N289) where the use of an operating microscope is clinically required for the procedure.
- Apply this premium when performing nerve tumour excision (e.g., N286) that necessitates magnification to distinguish nerve fascicles from tumour tissue.
Common Pitfalls
- Do not bill E906 for procedures using only surgical loupes; the Ministry requires the use of an operating microscope for this 40% premium.
- Avoid applying E906 to procedures not explicitly listed in the Schedule of Benefits as eligible for this specific microscope premium, even if a microscope was utilized.
- Ensure the base surgical code is submitted with the -A suffix; the premium will be rejected if the base code is not correctly identified as a surgical procedure.
Billing Tips
- Document the use of the operating microscope in the operative report to substantiate the claim in the event of a Ministry audit.
- E906 is a percentage-based premium; ensure your billing software calculates the 40% increase correctly against the base fee of the primary surgical procedure.
Percentage Premium: 0.4%
This code applies a percentage increase to the base procedure fee
Effective: July 1, 2013
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
PercentageIncrease
Other Premiums (including After Hours Procedure Premiums)
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