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E947
E947 – Maxillectomy with orbital exenteration
OHIP Surgical Assists Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This service represents the additional surgical work of an orbital exenteration performed during the same operative session as a partial or complete maxillectomy. This code must be claimed in addition to M056A.
When to Use
- Use E947 exclusively as an add-on when an orbital exenteration is performed concurrently with a maxillectomy (M056A).
- Apply this code when the surgical plan necessitates the removal of the orbital contents due to tumor involvement during the primary maxillectomy procedure.
Common Pitfalls
- Claiming E947 as a standalone procedure; it is strictly an add-on code and will be rejected if billed without M056A.
- Failing to account for the 85% payment adjustment rule, as E947 is considered a secondary procedure when performed under the same anesthetic as the primary maxillectomy.
Billing Tips
- Ensure the operative report explicitly details the orbital exenteration steps to support the use of E947 in addition to the primary M056A maxillectomy claim.
Provider Fee$306.85
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Respiratory Surgical Procedures
As with any surgical procedure, an operative report and appropriate medical records documenting the service must be maintained (see :22).
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