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E157
E157 – Placement and/or suturing of iris prosthetic device
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Placement and suturing of iris prosthetic device with or without suturing of iris/pupillary defect. The phrase with or without indicates that the suturing of the iris/pupillary defect is an optional component of the service. If performed, it is included in the fee for E157 and is not billed separately (:).
When to Use
- Use E157 when performing the primary surgical implantation of an iris prosthetic device to address iris coloboma or traumatic iris loss.
- Use E157 when the procedure includes the optional suturing of an iris or pupillary defect, as this is bundled into the code fee.
Common Pitfalls
- Do not bill E950 (intraocular lens insertion) on the same claim as E157, as these are mutually exclusive and will trigger a rejection.
- Do not attempt to bill iris or pupillary defect repair as a separate procedure, as the Schedule of Benefits explicitly includes this in the E157 fee.
Billing Tips
- Ensure the surgical report clearly documents the placement of the iris prosthetic to support the claim, especially if the secondary suturing component was also performed.
Provider Fee$550.00
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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