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E104

E104 – Removal of intraocular foreign body

OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits

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Removal of intraocular foreign body. This is a surgical procedure listed in the 'Ocular and Aural Surgical Procedures' section of the Schedule of Benefits. Payment includes fees for the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C), with assistant and anaesthesia fees calculated based on a system of basic and time units.

When to Use

  • Use E104 for the surgical removal of a foreign body located within the globe, distinct from superficial corneal foreign body removal which is typically billed under E105.
  • Apply E104 when the procedure requires an intraocular approach, such as entering the anterior or posterior chamber, rather than simple surface extraction.

Common Pitfalls

  • Billing E104 in conjunction with E105 or E106 for the same eye on the same day will trigger a rejection for duplicate or overlapping services.
  • Failure to document the specific intraocular location of the foreign body often leads to audit adjustments, as the Ministry distinguishes between superficial and intraocular procedures.
  • Attempting to claim E420 (Trauma Premium) alongside after-hours premiums (E409/E410) will result in a rejection, as these are mutually exclusive.

Billing Tips

  • Ensure the Injury Severity Score (ISS) is explicitly recorded in the operative report if claiming the E420 trauma premium to satisfy audit requirements.
  • When billing after-hours premiums (E409/E410), ensure the procedure start time is clearly noted in the chart to support the claim against the Ministry's time-stamping criteria.
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Provider Fee$542.00
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 30.3% vs 57.0% CPI inflation
Category

Y. Ocular and Aural Surgical Procedures

Subcategory

OCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Ocular and Aural Surgical Procedures

E105E106E107

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E104 – Removal of intraocular foreign body | OHIP Fee Schedule | SnapBill MD