E194 – Distichiasis repair or trichiasis repair by tarsal transplantation - unilateral
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
The code E194 is for the unilateral surgical repair of distichiasis, which is the abnormal growth of eyelashes from the orifices of the meibomian glands on the posterior lamella of the tarsal plate. This service is designated with a '#' prefix. When performed in a hospital or an Integrated Community Health Services Centre (ICHSC), the premises, equipment, supplies, and personnel are funded through the facility and not billed separately by the physician. See . The fee for this procedure depends on the role of the physician: - Surgeon (Suffix A): A set surgical fee is payable. - Surgical Assistant (Suffix B): The fee is unit-based. This procedure is assigned 6 basic units for the assistant. See - for full calculation details. - Anaesthesiologist (Suffix C): The fee is unit-based. This procedure is assigned 6 basic units for the anaesthetist. See - for full calculation details.
When to Use
- Use E194 for the surgical correction of distichiasis where a tarsal graft is required to reposition the abnormal eyelash follicles.
- Use E194 for trichiasis repair specifically involving tarsal transplantation, distinguishing it from simpler procedures like epilation or electrolysis.
Common Pitfalls
- Billing E194 bilaterally; the code is strictly unilateral, and a second unit or bilateral modifier will result in rejection or audit.
- Confusing E194 with simpler eyelid margin procedures; ensure the operative report explicitly details the tarsal transplantation to justify the higher fee compared to minor lid surgeries.
Billing Tips
- Ensure the operative report clearly documents the tarsal transplantation technique, as this is the defining requirement for E194 versus other eyelid reconstruction codes.
Effective: April 1, 2026
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures
All insured services must be documented in the patient's medical record, establishing that the service was provided, medically necessary, and is the service for which the account is submitted. An operative report is required for surgical procedures.
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