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E974
E974 – Pericranial flap to orbit or face - when in conjunction with coronal approach for main operation
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee is payable to the surgeon in addition to the fee for the main operation, R655 (bilateral pericranial flap to orbit or face), when a coronal approach is utilized for the main operation.
When to Use
- Use E974 exclusively as an add-on to R655 when the surgical plan necessitates a coronal incision to access the pericranial flap for orbital or facial reconstruction.
- Apply this code when the coronal approach is the primary surgical access point for the main procedure, fulfilling the specific requirement for the flap harvest.
Common Pitfalls
- Billing E974 without R655 on the same claim will result in an automatic rejection, as it is strictly defined as an add-on code.
- Attempting to bill E974 for flap procedures that do not utilize a coronal approach, or using it with codes other than R655, constitutes an invalid claim submission.
Billing Tips
- Ensure the operative report explicitly documents the use of a coronal approach to justify the E974 add-on, as this is the primary audit trigger for this code.
Provider Fee$297.55
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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