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E107

E107Penetrating wound - without prolapse of intraocular tissue

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

This service is for the surgical repair of a penetrating wound of the eyeball where there is no prolapse of intraocular tissue. The fee for the surgeon is claimed with suffix 'A'. Fees for a surgical assistant (suffix 'B') and an anaesthesiologist (suffix 'C') are also payable and calculated based on basic and time units. See 'Unit-Based Info' for details. The service includes common and specific elements as defined in the Schedule of Benefits, such as pre-operative preparation, the procedure itself, and immediate post-operative care.

When to Use

  • Use E107A for the primary repair of a corneal or scleral laceration where the wound is full-thickness but no uveal or vitreous tissue has prolapsed.
  • Select E107A when the surgical intervention is limited to suturing the wound edges without the need for complex tissue repositioning or excision required in E108A.

Common Pitfalls

  • Billing E107A when tissue prolapse is present, which necessitates the higher-valued E108A code; this will trigger an audit for clinical discrepancy.
  • Attempting to claim a second surgical assistant without prior authorization, as E107A is not on the pre-approved list for multiple assistants.

Billing Tips

  • Ensure the operative report explicitly states 'no prolapse of intraocular tissue' to justify the use of E107A over E108A during a post-payment review.
  • If the procedure is performed after hours, remember to append the appropriate surgical assistant special visit premium (C998B, C999B, or C983B) if the criteria for travel and non-elective status are met.
Provider Fee$496.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

Category

Y. Ocular and Aural Surgical Procedures

Subcategory

OCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Ocular and Aural Surgical Procedures

A second assistant's service requires authorization by a medical consultant unless the procedure is on the pre-approved list (). E107 is not on this list.

Services rendered by a Medical Trainee (Resident or Clinical Fellow) under the supervision of a Supervising Physician may be payable to the Supervising Physician subject to the rules and conditions outlined in the Schedule of Benefits (-).

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