E170 – Decompression - Three Walls
OHIP Surgical Assists Code — Orbit · Schedule of Benefits
Orbital decompression involving three walls. This is a surgical procedure listed under Ocular and Aural Surgical Procedures. Payment is eligible for the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C).
- Assistant Fee: Calculated based on 6 base units (Asst column) plus time units as per the rules on and .
- Anaesthesia Fee: Calculated based on 6 base units (Anae column) plus time units as per the rules on and . Additional extra units may apply based on patient factors as outlined on .
When to Use
- Use E170 specifically for orbital decompression surgery when exactly three walls are decompressed, distinguishing it from E169 which is typically used for lesser or different orbital procedures.
- Apply this code for non-elective or emergency orbital decompression cases where the surgical intent is to address severe proptosis or optic nerve compression requiring three-wall involvement.
Common Pitfalls
- Billing E170 alongside other orbital procedures without ensuring the surgical record clearly delineates the three walls addressed, which risks a rejection for unbundling or duplicate service.
- Failing to document the specific walls decompressed (e.g., medial, lateral, floor) can lead to audit recovery if the claim is flagged for lacking sufficient operative detail to justify the three-wall fee.
Billing Tips
- Ensure the surgical assistant and anaesthesiologist use the appropriate suffixes (B and C respectively) and that their time units are calculated strictly according to the base units defined for E170 to avoid claim processing delays.
- If the procedure is performed after hours, ensure the correct premium (E400 series or E401 series) is appended to the respective provider's claim, as these are calculated based on the case commencement time.
Effective: April 1, 2025
Ocular and Aural Surgical Procedures
Orbit
Surgical
Ocular and Aural Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.