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E202
E202 – Corneal cross-linking
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Corneal cross-linking
When to Use
- Use E202 for patients with documented progressive keratoconus where corneal imaging confirms worsening ectasia.
- Use E202 for post-refractive surgery patients presenting with secondary corneal ectasia.
- Use E202 for patients with pellucid marginal corneal degeneration requiring stabilization.
Common Pitfalls
- Billing E202 on the same day as E117 will result in a rejection, as these are mutually exclusive procedures.
- Failure to document the specific medical indication (e.g., progressive keratoconus) in the chart creates significant audit risk, as the code is strictly limited to the four listed indications.
- Attempting to bill E202 for non-progressive or stable keratoconus is ineligible for payment.
Billing Tips
- Ensure the clinical record explicitly states the progression of the condition, as this is the primary requirement for eligibility under the Schedule of Benefits.
Provider Fee$200.00
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
OCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Ocular and Aural Surgical Procedures
Corneal Cross Linking (CXL) is eligible for payment if the patient has one of the following medical indications: a. Mild to moderate progressive keratoconus; b. Corneal thinning or ectasia following laser photorefractive or phototherapeutic surgery; c. Pellucid marginal corneal degeneration; and d. Recurrent keratoconus after corneal transplantation.
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