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E200
E200 – Excision of skin, with or without partial excision of the orbicularis oculi muscle - one lid
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
excision of skin, with or without partial excision of the orbicularis oculi muscle - one lid
When to Use
- Use E200 for functional blepharoplasty procedures where the excision is limited to skin and partial orbicularis oculi muscle on a single eyelid.
- Select E200 when performing a wedge resection or simple excision for benign lesions or functional obstruction, provided prior Ministry approval is obtained under Appendix D.
Common Pitfalls
- Billing E200 without an approved Appendix D pre-authorization will result in automatic rejection, as this is a restricted cosmetic-prone procedure.
- Attempting to bill E200 alongside E201 (excision of skin and muscle with orbital fat) is a common error; ensure the procedure strictly matches the anatomical scope of E200 to avoid audit flags for upcoding.
Billing Tips
- Ensure the claim includes the approved pre-authorization number in the appropriate field to bypass the Ministry's automated rejection for non-insured cosmetic services.
Provider Fee$82.80
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
OCULAR SURGICAL PROCEDURES
Service Type
Other
Code Classes
Integumentary System Surgical Procedures
Pre-Authorization Required
Blepharoplasty is only insured in those circumstances described in the Appendix D - prior approval of the Ministry of Health is required.
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