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M089
M089 – Creation of tracheo-oesophageal fistula
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure to create an opening or fistula between the trachea and the esophagus. This is typically done to facilitate voice restoration, often after a total laryngectomy, by allowing the placement of a voice prosthesis.
When to Use
- Use M089 for the primary creation of a tracheo-oesophageal fistula to facilitate the placement of a voice prosthesis following a total laryngectomy.
- Use this code when performing a surgical revision or initial creation of the fistula tract to restore speech function in post-laryngectomy patients.
Common Pitfalls
- Do not bill M089 in conjunction with other major laryngeal or tracheal procedures without applying the 85% rule for secondary procedures as per SP3.
- Failure to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium will result in automatic rejection of the premium.
Billing Tips
- If the procedure is performed after hours, ensure the claim includes the appropriate E-code (E409 or E410) to increase the procedural fee by 50% or 75% respectively, provided the case is non-elective.
Provider Fee$234.60
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Code Classes
Respiratory Surgical Procedures
If claiming the Trauma premium (E420), the medical record must list the patient's Injury Severity Score (ISS). (See )
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