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E235
E235 – Cantholysis - when primary procedure
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
Cantholysis - when primary procedure. An anaesthesia service with 6 base units is payable. An assistant's service is not payable. Suffixes A (surgeon) and C (anaesthetist) are applicable.
When to Use
- Use E235 as the primary procedure code when performing a lateral or medial cantholysis for orbital decompression or emergency eyelid release.
- Select E235 when the procedure is performed as a standalone intervention, ensuring it is not bundled into more comprehensive eyelid reconstruction codes like E140 or E141.
Common Pitfalls
- Attempting to bill E235 alongside E140 or E141 will result in an automatic rejection due to the restricted code pairing.
- Claiming an assistant fee for this procedure is a common billing error, as the schedule explicitly states an assistant's service is not payable for E235.
Billing Tips
- Ensure the anaesthetist uses suffix C and claims the 6 base units associated with this procedure to avoid payment discrepancies.
- Apply the appropriate age-based surgical premium (e.g., under 16 years) to the E235 fee if the patient meets the specific age criteria.
Provider Fee$107.50
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
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
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