All codes
E219
E219 – Lacrimal bypass procedure (e.g. Lester Jones) - when sole procedure (both stages)
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
E219 is for a lacrimal bypass procedure, such as a Lester Jones procedure, when it is the sole procedure performed. The fee for this service includes both stages of the procedure.
When to Use
- Use E219 when performing a complete Lester Jones tube placement as a standalone procedure, covering the entire surgical process in one billing entry.
- Use this code for lacrimal bypass surgeries where no other concurrent ocular procedures are performed, ensuring the 'sole procedure' requirement is met.
Common Pitfalls
- Do not bill E219 in conjunction with other ocular surgical codes, as the 'sole procedure' constraint will trigger an automatic rejection or audit flag.
- Avoid billing separate stages of the bypass procedure; E219 is an all-inclusive fee intended to cover the entire surgical sequence.
Billing Tips
- Ensure the operative report clearly details the bypass procedure to justify the use of E219 over more specific lacrimal codes like E218 if the scope of work differs.
- Apply age-based premiums (e.g., AGE_PREMIUM_UNDER_16_YEARS) to the E219 base fee if the patient meets the specific age criteria to maximize the claim value.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.