E137 – Needling (Discission) - Primary or Subsequent.
OHIP Surgical Assists Code — Crystalline Lens · Schedule of Benefits
This service is for the needling (discission) of the crystalline lens. It can be a primary procedure or a subsequent one. The fee for the surgeon (suffix A) is a flat rate. Fees for surgical assistant (suffix B) and anaesthetist (suffix C) are calculated based on a combination of base units and time units, with specific rules and restrictions applying to anaesthesia. As per the commentary on page , local infiltration or topical anaesthesia used for this procedure is not an insured service.
When to Use
- Use E137 for the primary surgical discission of the crystalline lens when addressing opacification.
- Use E137 for subsequent needling procedures required to clear secondary lens opacification or capsular remnants.
Common Pitfalls
- Billing E137C (anaesthesia) without realizing it is restricted to only 5 base units with no time units; use E023C instead to capture 6 base units plus time and extra units.
- Attempting to bill for local infiltration or topical anaesthesia, which is explicitly excluded from payment per the Schedule of Benefits.
- Submitting E137 alongside restricted codes like E003C or E021C, which will trigger an automatic rejection.
Billing Tips
- Always bill E023C for anaesthesia services associated with E137 to maximize reimbursement through base units, time units, and eligible extra units.
- Ensure the surgical assistant fee (E137B) is calculated using the 6 base units plus time units as specified in the GP86 section.
Effective: April 1, 2025
Ocular and Aural Surgical Procedures
Crystalline Lens
Surgical
Ocular and Aural Surgical Procedures
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