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M015
M015 – Septodermoplasty
OHIP Respiratory Surgical Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This is a surgical procedure from the Respiratory Surgical Procedures section of the Schedule of Benefits. The specific listing for M015 is 'Septodermoplasty (to include fascial and other grafts)'. The fee for this service includes the associated pre-operative and post-operative care as defined in the Surgical Preamble. According to , this includes pre-operative hospital visits which take place 1 or 2 days prior to surgery, and post-operative care and visits associated with the procedure for up to two weeks post-operatively. Exceptions to the included post-operative care are the first and second post-operative visits in hospital (payable at the specialty specific subsequent visit fee) and the subsequent visit by the Most Responsible Physician (MRP) on the day of discharge (C124). The major pre-operative visit (the consultation or assessment where the decision to operate is made) is not included in the surgical fee and can be billed separately. A hospital admission assessment by the surgeon is not eligible for payment unless it is the major pre-operative visit as per .
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
The assistant fee for this service is not payable, as per the master fee record. According to , this occurs when 'nil' is listed in the 'Asst' column for the procedure in the Schedule of Benefits.
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