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E156
E156 – Intraocular suturing of iris/pupillary defect
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
E156 is a surgical procedure for the intraocular suturing of an iris or pupillary defect. This service is not eligible for payment for the repair of iris tears that are a result of cataract extraction. Additionally, the insertion of an intraocular lens, billed as E950, is not payable in conjunction with E156.
When to Use
- Use E156 for the surgical repair of traumatic iris defects or iridodialysis where the iris tissue is intact but requires suturing to the scleral wall or pupillary margin.
- Use E156 for the repair of congenital iris coloboma when the procedure is performed as a distinct surgical intervention unrelated to cataract surgery.
Common Pitfalls
- Billing E156 for iris repairs performed during cataract extraction will result in automatic rejection, as this is considered an inherent part of the cataract procedure.
- Submitting E156 alongside E950 (intraocular lens insertion) will trigger a claim rejection due to the explicit billing restriction between these two codes.
- Failure to document the non-cataract-related nature of the iris defect can lead to audit recovery if the claim is flagged for review.
Billing Tips
- If the iris repair is performed as part of a complex ocular trauma case, ensure the operative report clearly distinguishes the iris suturing from any concurrent lens management to avoid confusion with the E950 restriction.
Provider Fee$350.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
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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