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E963

E963LeFort I intrusion - in two segments

OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

This service is an add-on fee payable to the surgeon when performing a LeFort I intrusion in two segments. This code must be billed in conjunction with `R538A (LeFort I intrusion, in one segment). The combination of R538A` and E963A constitutes the total fee for a two-segment LeFort I intrusion.

When to Use

  • Use E963 only when performing a LeFort I osteotomy that involves a mid-line split or multi-segmental intrusion to achieve the desired occlusal correction.
  • This code must be submitted as an add-on alongside R538A to accurately reflect the complexity of a two-segment intrusion procedure.

Common Pitfalls

  • Billing E963 in isolation without R538A will result in an automatic rejection, as it is strictly an add-on code.
  • Attempting to use E963 for a single-segment intrusion is a billing error; ensure the surgical plan explicitly documents the two-segment requirement.

Billing Tips

  • Ensure both R538A and E963 are submitted on the same claim to ensure the total procedural fee is processed correctly.
Provider Fee$296.60

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Procedure

Code Classes

Musculoskeletal System Surgical Procedures

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