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E221
E221 – Laceration of eyelid including levator palpebrae superioris with ptosis
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Laceration of eyelid including levator palpebrae superioris with ptosis. This is a surgical procedure to repair a deep cut of the eyelid that affects the muscle responsible for lifting the eyelid.
When to Use
- Use E221 specifically for full-thickness eyelid lacerations that involve the levator palpebrae superioris muscle and result in clinically documented ptosis.
- Use E221 when the repair requires specialized surgical reattachment of the levator muscle, distinguishing it from simple superficial laceration repairs like E220.
Common Pitfalls
- Billing E221 for simple eyelid lacerations that do not involve the levator muscle or ptosis, which will lead to audit recovery for over-billing.
- Failing to document the presence of ptosis and the specific involvement of the levator muscle in the operative report, which is required to justify the higher fee compared to standard eyelid repair codes.
- Attempting to bill additional repair codes for the same eyelid; E221 is intended to be a comprehensive code for the complex repair described.
Billing Tips
- Ensure the operative note explicitly describes the identification and repair of the levator palpebrae superioris to support the use of this specific code over general eyelid laceration codes.
- Apply the appropriate age-based premium if the patient is under 16 years old, as these are automatically eligible for E221.
Provider Fee$645.35
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72
Effective: April 1, 2026
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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