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E964
E964 – LeFort I intrusion - in three segments
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This billing code represents an additional fee for a LeFort I intrusion procedure that is performed in three segments. It is to be claimed in addition to R538, which covers the LeFort I intrusion in a single segment.
When to Use
- Use E964 when performing a LeFort I osteotomy specifically involving the segmentation of the maxilla into three distinct pieces to achieve the desired intrusion.
- Claim this code only when the primary procedure R538 (LeFort I intrusion, single segment) is also billed on the same claim.
Common Pitfalls
- Billing E964 without R538 will result in an automatic rejection as it is strictly an add-on code.
- Confusing E964 with E963; ensure you are specifically billing for a three-segment intrusion rather than a two-segment procedure.
Billing Tips
- Ensure your operative report explicitly documents the segmentation of the maxilla into three pieces to justify the additional fee over the base R538 code.
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