E328 – Tympanotomy
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
Tympanotomy is a surgical incision into the tympanic membrane. It is eligible for surgeon (suffix A), anaesthetist (suffix C), and, with special authorization, assistant (suffix B) fees. Anaesthesia services are calculated with 10 base units plus time units. If a middle ear tumour is also removed, this is claimed as an add-on service using E981A. This procedure is eligible for various premiums including age-based premiums for patients under 16, after-hours premiums, and the trauma premium (E420).
When to Use
- Use E328 for a surgical incision into the tympanic membrane when performed as a standalone procedure.
- Use E328 in conjunction with E981A when a middle ear tumour is removed concurrently during the same operative session.
Common Pitfalls
- Attempting to bill an assistant (suffix B) without prior special authorization from a medical consultant, which will result in automatic rejection.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium, which is a mandatory audit requirement.
- Incorrectly applying after-hours premiums (E409/E410) to elective procedures that were not delayed by an intervening surgical emergency.
Billing Tips
- When claiming for a surgical assistant, use M400B and ensure you submit a letter from the surgeon justifying the necessity of the assistant to secure the required authorization.
- Always verify the patient's exact age at the time of the procedure to ensure the correct age-based surgical premium (ranging from 10% to 30%) is applied to the E328 base fee.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
Y. Ocular and Aural Surgical Procedures
Surgical
Ocular and Aural Surgical Procedures
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