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E131
E131 – Laser iridotomy
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Performs a laser iridotomy, a surgical procedure on the iris and ciliary body. As a surgical procedure, payment includes associated pre-operative and post-operative care. This service can be billed by the surgeon (suffix A), an assistant (suffix B), and an anaesthetist (suffix C). Fees for the assistant and anaesthetist are calculated based on basic and time units.
When to Use
- Use E131 for laser peripheral iridotomy (LPI) performed to treat or prevent angle-closure glaucoma.
- Use E131 when creating a drainage opening in the iris via laser, distinct from E130 (laser trabeculoplasty) which targets the trabecular meshwork.
Common Pitfalls
- Billing E131 alongside a consultation or assessment on the same day is generally disallowed as the fee includes pre-operative and post-operative care.
- Attempting to bill E131 bilaterally without clear clinical documentation of medical necessity for both eyes on the same date can lead to audit scrutiny.
- Confusing E131 with E134 (laser capsulotomy) or E130 (laser trabeculoplasty) will result in claim rejection or recovery.
Billing Tips
- Ensure the procedure is documented as a surgical event, as the fee is all-inclusive of the immediate pre- and post-operative management.
- If performing the procedure after hours for a non-elective indication, ensure the claim includes the appropriate E-series after-hours premium to avoid underpayment.
Provider Fee$161.75
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
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
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