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E178
E178 – Free mucous membrane graft - full thickness
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision and grafting of a full thickness free mucous membrane graft for orbital reconstruction. This service is categorized under 'Ocular and Aural Surgical Procedures'. Assistant Services: Payment for an assistant's service (suffix B) for E178 is not directly payable. Assistance at surgery requires submission under M400B with independent consideration, using the anaesthesia base units (7). A letter from the surgeon outlining the reason the assistant was required must be submitted (see ).
When to Use
- Use E178 specifically for full-thickness free mucous membrane grafts required for orbital socket reconstruction or repair of conjunctival defects.
- Select E178 when the surgical procedure involves the harvesting and transplantation of a full-thickness graft, distinguishing it from partial-thickness procedures or simple mucosal repairs.
Common Pitfalls
- Attempting to bill an assistant using the suffix B directly on E178 will result in rejection; you must bill M400B with independent consideration.
- Failure to document the specific clinical necessity for an assistant in a formal letter to the Ministry will lead to the denial of the M400B claim.
Billing Tips
- Ensure the surgical report clearly describes the full-thickness nature of the graft to support the E178 fee, as this distinguishes it from lower-value mucosal procedures.
- When billing M400B for an assistant, ensure the anaesthesia base units are correctly identified as 7 to facilitate the independent consideration process.
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