M133 – Thoracotomy for removal of foreign body
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Thoracotomy for removal of a foreign body is a major surgical procedure. It involves making an incision through the chest wall to access the thoracic cavity, allowing the surgeon to locate and remove a foreign object. The fee for this service includes standard pre-operative care (visits 1-2 days before surgery) and post-operative care for up to two weeks, with the exception of the first two post-operative visits which are separately billable (see Surgical Preamble for details). The surgical benefit includes the generally accepted surgical components of the procedure.
When to Use
- Use M133 when performing an open thoracotomy specifically to retrieve an aspirated or embedded foreign body from the thoracic cavity.
- Use M133 for the surgical removal of a retained foreign object following previous thoracic intervention or trauma when an open approach is required.
Common Pitfalls
- Billing for hospital visits occurring 1-2 days pre-operatively or during the 14-day post-operative period, as these are included in the M133 surgical fee.
- Attempting to bill a consultation fee (e.g., A005) in addition to M133 for the same patient encounter when the decision to operate is made during that visit.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium for M133.
Billing Tips
- Ensure you bill the first and second post-operative hospital visits separately using the appropriate subsequent visit code, as these are the only visits excluded from the M133 global fee.
- If the procedure is abandoned after commencement, submit the claim under R990 with the operative report attached to justify the partial fee.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
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