E332 – Labyrinthotomy or labyrinthectomy
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
This service is for a labyrinthotomy or labyrinthectomy, which may include the Fick procedure. The fee listed is for the primary surgeon (suffix A).
- Anaesthesia (`suffix C`): Payable with 10 base units plus time units as per .
- Surgical Assistant (`suffix B`): The Schedule does not list basic units for an assistant. However, assistance may be claimed if medically necessary, subject to independent consideration by a medical consultant. Claims for assistance should be submitted using fee code M400B, with 10 basic units (derived from the anaesthesia units as per ) plus time units.
When to Use
- Use E332 for a primary labyrinthotomy or labyrinthectomy procedure, including the Fick procedure, performed for conditions such as intractable Meniere's disease.
- Use this code when the surgical intent is the destruction or opening of the labyrinth, distinguishing it from simple mastoidectomy or middle ear procedures.
Common Pitfalls
- Billing for a surgical assistant using E332B directly will result in rejection; you must use M400B and provide a letter of medical necessity to the medical consultant.
- Failing to document the specific surgical approach or the necessity of the assistant can lead to the denial of the M400B claim during the independent consideration process.
Billing Tips
- Ensure the claim for M400B includes a clear, concise justification from the surgeon regarding the complexity or technical requirements that necessitated an assistant for this specific procedure.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
Y. Ocular and Aural Surgical Procedures
Surgical
Ocular and Aural Surgical Procedures
Payment for a surgical assistant (suffix B) requires authorization by a medical consultant and must be submitted using fee code M400B. The claim should include a letter from the surgeon outlining the reason the assistant was required. See .
The fee for this procedure is eligible for age-based premiums for patients under 16 years of age, as outlined on page .
After-hours and trauma premiums may be applicable under specific circumstances as defined in the General Preamble (, , , ).
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