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E185
E185 – Horizontal or vertical rectus muscle repair
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E185 for the surgical recession or resection of a horizontal rectus muscle (medial or lateral) to treat strabismus.
- Use E185 for the surgical recession or resection of a vertical rectus muscle (superior or inferior) to treat strabismus.
- Use E185 when performing a muscle repair that does not meet the specific criteria for E182 (recession), E183 (resection), or E184 (recession/resection combination) if your specific surgical technique or clinical documentation aligns better with the general repair definition.
Common Pitfalls
- Exceeding the maximum of 4 strabismus muscle procedures per patient per day; any combination of E182, E183, E184, or E185 beyond 4 will be rejected.
- Failing to document the use of adjustable sutures when billing E949; this flat fee is only payable if the adjustable technique is explicitly utilized and noted for the specific muscle procedure.
- Incorrectly applying the E877 repeat procedure premium to a primary surgery; this 30% premium is strictly reserved for re-operations on the same muscle.
Billing Tips
- Always ensure the number of muscles operated on matches the number of procedure codes submitted, keeping the total count at or below 4 per day.
- If performing an adjustable suture, bill E949 on the same claim as the primary E185 procedure to ensure the flat fee is triggered correctly.
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