E207 – Pterygium - with lamellar graft
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical excision of a pterygium with the placement of a lamellar graft. This procedure is designated as unilateral. - The surgeon's service is claimed with suffix 'A'. - An assistant's service is eligible for payment and is claimed with suffix 'B'. The fee is calculated based on 6 basic units plus time units as per the rules on -. - An anaesthetist's service is eligible for payment and is claimed with suffix 'C'. The fee is calculated based on 6 basic units plus time units as per the rules on -.
When to Use
- Use E207 when performing a formal pterygium excision specifically utilizing a lamellar graft to cover the bare sclera.
- Choose E207 over E205 or E206 when the surgical technique requires the harvesting and suturing of a lamellar graft rather than simple excision or primary closure.
Common Pitfalls
- Claiming E207 bilaterally on the same day without appropriate manual review or documentation, as the code is strictly designated as unilateral.
- Failing to include the E948 add-on code when a mucous membrane graft is specifically utilized in conjunction with the lamellar graft procedure.
Billing Tips
- Always append the 'A' suffix to E207 for the surgeon's claim and ensure the assistant and anaesthetist use suffixes 'B' and 'C' respectively to trigger the correct unit-based fee calculations.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
OCULAR SURGICAL PROCEDURES
Surgical
Ocular and Aural Surgical Procedures
The assistant's service (suffix B) is calculated based on 6 basic units plus time units. See and for calculation rules.
The anaesthetist's service (suffix C) is calculated based on 6 basic units plus time units. See and for calculation rules.
The description for the related code E206 specifies it is unilateral, which implies E207 is also unilateral.
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