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E167
E167 – Tumour or foreign body - posterior exposure
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Excision of a tumour or foreign body from the orbit via a posterior exposure approach. This is a surgical procedure listed in the Ocular and Aural Surgical Procedures section of the Schedule of Benefits. As a surgical procedure, it includes all pre-operative and post-operative care associated with the surgery. It requires a posterior exposure for access.
When to Use
- Use E167 for the surgical removal of an orbital tumour or foreign body specifically requiring a posterior approach, such as a lateral orbitotomy.
- Select E167 when the procedure is deeper than the anterior orbit, distinguishing it from superficial excision codes like E165 or E166.
Common Pitfalls
- Billing E167 alongside other orbital exploration codes (e.g., E168) for the same anatomical site is considered unbundling and will lead to claim rejection.
- Failure to document the specific posterior surgical approach (e.g., lateral or transcranial) often triggers audit flags, as the fee is predicated on the complexity of the exposure.
Billing Tips
- Ensure the operative report explicitly details the posterior exposure technique, as this is the defining requirement for the E167 fee over simpler orbital procedures.
Provider Fee$1,114.05
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
Since Apr 2004, this fee has increased 116.4% vs 58.5% CPI inflation
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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