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E966
E966 – LeFort I extrusion - in three segments
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is an add-on fee for a LeFort I extrusion procedure when the maxilla is surgically sectioned into three separate segments. It must be claimed in addition to `R567A (LeFort I extrusion in one segment). The primary procedure, R567`, includes the harvesting and grafting of bone or cartilage grafts as noted on .
When to Use
- Use this code when performing a LeFort I osteotomy where the maxilla is specifically divided into three distinct segments to achieve the desired surgical correction.
- This code must be used in conjunction with the primary procedure R567 (LeFort I extrusion) to account for the increased complexity of multi-segment fixation.
Common Pitfalls
- Billing E966 without the primary R567 code will result in an automatic rejection as it is strictly an add-on fee.
- Attempting to bill E966 alongside E965 is prohibited; ensure you are selecting the correct segment-count code based on the actual intraoperative osteotomy performed.
- Failure to document the specific three-segment osteotomy in the operative report creates an audit risk, as the claim must justify the additional complexity over a single-segment procedure.
Billing Tips
- Always ensure E966 is submitted on the same claim as R567 to maintain the necessary billing link for the primary procedure.
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