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E309
E309 – Pre-auricular sinus - general anaesthetic
OHIP Surgical Assists Code — AURAL SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical excision of a pre-auricular sinus. It is specifically designated for cases requiring a general anaesthetic, typically performed in a hospital setting. This contrasts with Z903, which is for the same condition but does not involve a general anaesthetic. The service includes all pre-operative, intra-operative, and post-operative care as defined in the surgical preamble.
When to Use
- Use E309 when the pre-auricular sinus excision is performed in a hospital operating room under general anaesthesia, typically for pediatric patients or complex, recurrent cases.
- Use E309 for cases where the patient's age or clinical anxiety necessitates general anaesthesia, distinguishing it from the office-based local anaesthetic procedure Z903.
Common Pitfalls
- Billing E309 in conjunction with Z903 is a common error; these are mutually exclusive and the claim will be rejected as they represent the same procedure under different anaesthetic settings.
- Failing to apply the mandatory age-based premiums for pediatric patients, which are specifically eligible for this surgical code, results in significant under-billing.
Billing Tips
- Always verify the patient's age at the time of the procedure to ensure the correct percentage-based age premium is appended to the base fee of $208.05.
- If the procedure is performed after hours, ensure the appropriate E409 or E410 premium is applied to the total surgical fee to maximize reimbursement for non-elective cases.
Provider Fee$208.05
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
AURAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Ocular and Aural Surgical Procedures
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