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P053

P053Selective fetal reduction of one or more fetuses by bipolar or unipolar cautery of umbilical cord

OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits

The service involves the selective fetal reduction of one or more fetuses by applying bipolar or unipolar cautery to the umbilical cord. This procedure is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees. See the notes and billing interactions for additional payable services.

When to Use

  • Use P053 for selective reduction of a monochorionic pregnancy where bipolar or unipolar cautery is specifically utilized to occlude the umbilical cord.
  • Select P053 when performing fetal reduction in cases of discordant anomalies or complications requiring cord coagulation rather than simple intracardiac injection.

Common Pitfalls

  • Failing to bill J149 for ultrasonic guidance, which is a separate, payable service when performed alongside P053.
  • Incorrectly billing P053 for procedures involving radiofrequency ablation or other non-cautery methods, which may require different coding.
  • Omitting the Z552 code when applicable, as it is specifically listed as payable in addition to P053.

Billing Tips

  • Always ensure J149 is included on the same claim if ultrasonic guidance was provided, as it is not bundled into the P053 fee.
  • Apply the appropriate after-hours premiums (E409 or E410) if the procedure meets the non-elective criteria and timing requirements, as these are calculated as a percentage of the P053 base fee.
Provider Fee$248.85
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category

K. Obstetrics

Subcategory

OBSTETRICS

Service Type

Surgical

Code Classes

Obstetrics, Diagnostic and Therapeutic Procedures

All insured services must be documented in appropriate records establishing 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.

Sex Restriction

Female

Procedures listed under Maternal - Fetal Procedures are payable in addition to J149 Ultrasonic Guidance and/or Z552 Diagnostic Laparoscopy, where applicable.

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