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M130
M130 – Closure of broncho-pleural fistula
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Closure of broncho-pleural fistula (transthoracic or trans-sternal). The surgical fee includes pre-operative care (1-2 days prior to surgery) and post-operative care (up to two weeks), excluding the first two post-operative visits and the day-of-discharge visit as per the Surgical Preamble ().
When to Use
- Use M130 for the definitive surgical repair of a broncho-pleural fistula via a transthoracic approach.
- Use M130 when performing a trans-sternal closure of a broncho-pleural fistula, ensuring the operative report clearly details the approach.
Common Pitfalls
- Billing for post-operative visits within the 14-day global period, as these are included in the M130 fee, excluding the two allowed post-op visits and the discharge day.
- Failing to document the specific flap or tissue used when claiming E609 or E610, which leads to audit recovery if the operative note does not explicitly support the reinforcement method.
Billing Tips
- Always append E609 or E610 to the M130 claim if reinforcement is used, as these are flat-fee add-ons that significantly increase the total reimbursement for the procedure.
- Ensure the Injury Severity Score (ISS) is explicitly recorded in the chart if claiming the E420 trauma premium, as this is a mandatory requirement for audit compliance.
Provider Fee$584.75
Surgical Assistant Fee$112.59
Anaesthetist Fee$201.37
Non-Anaesthetist Fee$201.37
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Respiratory Surgical Procedures
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