E133 – Extraocular glaucoma procedures
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
This service covers extraocular glaucoma procedures. As a surgical procedure listed in the Ocular and Aural Surgical Procedures section, it is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees. The assistant fee includes 6 basic units, and the anaesthesia fee includes 6 basic units, with additional time units applicable for both based on the duration of the service as outlined in the General Preamble (, ). Various premiums may apply, such as those for after-hours services, age-based adjustments for patients under 16 (), and trauma (E420).
When to Use
- Use E133 for extraocular glaucoma procedures such as revision of a filtering bleb or other non-intraocular glaucoma surgeries.
- Select E133 when the procedure is specifically classified as extraocular, distinguishing it from intraocular procedures like trabeculectomy (E130) or goniotomy (E132).
Common Pitfalls
- Billing E133 alongside intraocular glaucoma procedures (e.g., E130) often triggers a rejection for 'incidental' or 'included' services; ensure the procedures are distinct and medically necessary.
- Failure to document the specific extraocular nature of the procedure can lead to audit reclassification if the Ministry interprets the service as an intraocular intervention.
Billing Tips
- Ensure that if an assistant or anaesthetist is required, they bill their respective units (6 basic units) in addition to the E133 procedural fee to avoid under-billing.
- Verify that any after-hours premiums (E409/E410) are applied only if the procedure meets the non-elective criteria, as E133 is frequently performed as an elective, scheduled service.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures
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