E155 – Cryopexy - extraocular or sub-conjunctival - one eye
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Cryopexy - extraocular or sub-conjunctival - one eye is a surgical procedure for the retina. The service involves the application of intense cold via an extraocular or sub-conjunctival approach to treat retinal conditions in one eye, as listed in the Ocular and Aural Surgical Procedures section of the Schedule. This service is eligible for payment for a surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) based on the units specified in the Schedule of Benefits ().
When to Use
- Use E155 for the application of cryotherapy to the retina via an extraocular or sub-conjunctival approach to treat conditions such as retinal tears or peripheral retinal degeneration.
- Use E155 when performing prophylactic cryopexy in a patient with high-risk retinal pathology where an intraocular approach is not indicated.
Common Pitfalls
- Billing E155 bilaterally without using the appropriate eye modifiers (e.g., LT or RT) will result in automatic rejection; ensure each eye is billed as a separate line item if performed bilaterally.
- Attempting to bill E155 in conjunction with other retinal procedures like vitrectomy or scleral buckling may trigger bundling edits; verify the Schedule of Benefits for mutually exclusive codes.
Billing Tips
- Always append the appropriate eye modifier (LT or RT) to the E155 claim to clearly indicate which eye was treated, as the fee is strictly per eye.
- If the procedure is performed on an emergency basis after hours, ensure the claim includes the correct after-hours premium (E409 or E410) to avoid underpayment.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures
The service description specifies this procedure is for one eye.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.