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E335
E335 – Stapedectomy with prosthesis
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
A surgical procedure involving the removal of the stapes bone and insertion of a prosthesis to treat hearing loss. This service is eligible for surgeon fees (suffix A) and anaesthesia fees (suffix C). The anaesthesia service () is calculated with 10 base units () plus time units. Assistant services (suffix B) are not insured for this procedure. Additional premiums may apply, such as age-based premiums (), after-hours premiums (E409, E410, E400C, E401C), or the trauma premium (E420).
When to Use
- Use E335 for the definitive surgical management of otosclerosis involving the removal of the stapes bone and the placement of a prosthetic device.
- Select E335 when performing a revision stapedectomy where the primary objective is the replacement or adjustment of a previously inserted prosthesis.
Common Pitfalls
- Submitting a claim for an assistant (suffix B) will result in an automatic rejection, as E335 is not an insured service for surgical assistants.
- Billing E335 alongside other middle ear procedures (such as tympanoplasty or mastoidectomy codes) without proper documentation of separate incisions or distinct pathology may trigger audit flags for unbundling.
Billing Tips
- Ensure the anaesthesia claim (suffix C) correctly utilizes the 10 base units defined in Y17, as failure to include these base units will result in an underpayment of the anaesthesiologist's fee.
- If the procedure is performed after hours, ensure the claim includes the appropriate after-hours premium (E409 or E410) to increase the procedural fee by 50% or 75% respectively, provided the criteria for non-elective status are met.
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