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E208

E208Peritomy (Gunderson conjunctival flap)

OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits

Peritomy (Gunderson conjunctival flap) is an ocular surgical procedure involving the excision of conjunctiva. This procedure is eligible for surgeon, assistant, and anaesthesia fees. Anaesthesia for this service has 6 base units as per the Schedule of Benefits.

When to Use

  • Use E208 specifically for the surgical creation of a Gunderson conjunctival flap to cover a corneal defect or ulcer.
  • Use E208 when performing a formal peritomy as a distinct surgical procedure, rather than as a minor incidental step during other ocular surgeries.

Common Pitfalls

  • Billing E208 alongside other ocular procedures without ensuring the surgical site or nature of the procedure justifies a separate claim, which may trigger an audit for unbundling.
  • Failing to document the specific surgical technique of the Gunderson flap, which is required to differentiate E208 from more minor conjunctival excisions.

Billing Tips

  • Ensure that if an assistant or anaesthesiologist is present, they bill their respective premiums (e.g., E400B/C, E401B/C) based on the start time of the E208 procedure to maximize claim accuracy.
Provider Fee$225.00
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

Surgical

Code Classes

Ocular and Aural Surgical Procedures

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