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E316
E316 – Tympanotomy with fistula repair
OHIP Surgical Assists Code — AURAL SURGICAL PROCEDURES · Schedule of Benefits
Tympanotomy with fistula repair is a surgical procedure involving an incision into the tympanic membrane (tympanotomy) to repair a fistula in the middle ear. This service is eligible for surgeon (A) and anaesthetist (C) fees.
When to Use
- Use E316 when performing a formal surgical repair of a perilymphatic fistula following a tympanotomy, distinct from simple myringotomy or tube insertion.
- Select E316 for middle ear exploration and fistula closure when the primary clinical objective is the sealing of a confirmed or highly suspected fistula site.
Common Pitfalls
- Do not bill E316 in conjunction with routine myringotomy codes, as this may be flagged as unbundling if the fistula repair was not the primary documented surgical intent.
- Failure to document the specific location and nature of the fistula in the operative report is a common cause for audit recovery, as the procedure requires clear evidence of a defect repair.
Billing Tips
- Ensure the operative report explicitly details the fistula repair technique to justify the higher fee compared to standard tympanotomy procedures.
- If the procedure is performed on an emergency basis for trauma, ensure the E420 trauma premium is appended with the required ISS score documented to maximize the claim value.
Provider Fee$395.05
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
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
When claiming the E420 trauma premium, the medical record must list the Injury Severity Score (ISS).
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