E119 – Excision of dermoid - with lamellar graft
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Excision of a dermoid from the cornea, which includes a lamellar graft. This service is listed in the Ocular and Aural Surgical Procedures section of the Schedule of Benefits under the Cornea and Excision subheadings. This procedure is eligible for assistant and anaesthesia fees. When billed by the surgeon, use suffix <suffix>A</suffix>. When billed for an assistant, use suffix <suffix>B</suffix> with 6 base units. When billed for an anaesthetist, use suffix <suffix>C</suffix> with 6 base units.
When to Use
- Use E119 when performing a formal excision of a corneal dermoid that necessitates a lamellar keratoplasty to reconstruct the corneal surface.
- Choose E119 over simple excision codes like E118 if the procedure involves the harvesting or application of donor tissue to address the resulting corneal defect.
Common Pitfalls
- Billing E119 in conjunction with other corneal procedures like E121 or E122 without clear documentation of separate, distinct anatomical sites or procedures, which may trigger a rejection for unbundling.
- Failing to include the required 6 base units when billing for an assistant (suffix B) or anaesthetist (suffix C), which will result in an automatic claim rejection.
Billing Tips
- Ensure the operative report explicitly details the lamellar graft component, as this is the specific clinical requirement that differentiates E119 from simpler excision codes.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures
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