M105 – Chest wall tumour resection
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the resection of a chest wall tumour, which involves the removal of 2 or 3 ribs or cartilages. This procedure is eligible for anaesthesia and surgical assistant services, which are calculated based on time and base units. Additional procedures may be billed separately, such as E847 for diaphragm reconstruction or E640 for chest wall reconstruction.
When to Use
- Use M105 specifically for the resection of 2 or 3 ribs or cartilages as part of a chest wall tumour excision.
- Use M105 as the base code when performing a chest wall resection that necessitates concurrent sternal resection (add E602) or diaphragm reconstruction with mesh (add E847).
Common Pitfalls
- Failing to document the specific number of ribs or cartilages removed, which is required to justify the M105 code over other chest wall procedure codes.
- Attempting to bill for routine pre-operative or post-operative visits within the two-week global period, ignoring that only the first two in-hospital visits and the discharge visit are separately payable.
- Omitting the required documentation of the defect size (minimum 5 cm) when claiming the E640 reconstruction add-on.
Billing Tips
- Always bill the decision-to-operate consultation separately from M105, as it is not included in the surgical global fee.
- When performing multiple procedures during the same operative session, ensure the major procedure is billed at 100% and secondary procedures are adjusted to 85% per the Schedule of Benefits rules.
Effective: April 1, 2026
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
Payment for this surgical procedure includes pre-operative care for 1-2 days prior to surgery and post-operative care for up to two weeks following the procedure. However, the first and second post-operative visits in hospital and the day-of-discharge visit (C124) are payable separately at the specialty-specific subsequent visit fee.
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 claimed separately, regardless of the time interval before surgery.
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