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E336
E336 – Type 1 (myringoplasty with exploration of middle ear)
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
This service is for a Type 1 tympanoplasty, which includes myringoplasty and exploration of the middle ear. It is a surgical procedure to repair a perforation of the tympanic membrane (eardrum). Payment is for the surgeon (suffix A), and may also be claimed for an anaesthetist (suffix C) and a surgical assistant (suffix B), subject to the rules in the Schedule of Benefits. The procedure can be combined with additional procedures like a mastoidectomy (E957) or meatoplasty/canalplasty (E959) when medically necessary.
When to Use
- Use E336 for a primary tympanoplasty involving a myringoplasty and middle ear exploration to repair a tympanic membrane perforation.
- Use E336 when the procedure is performed as a standalone repair, distinct from more complex reconstructions like E337 (tympanoplasty with ossicular chain reconstruction).
Common Pitfalls
- Billing E336 with E337 is generally considered unbundling; ensure the documentation supports the specific complexity of the procedure performed.
- Failing to include the appropriate surgical assistant code (M400B) when the assistant's fee is not automatically listed, which requires a letter of justification to the Ministry.
- Omitting the required add-on codes E957 or E959 when a mastoidectomy or canalplasty is performed, as these are distinct billable additions to the primary E336 fee.
Billing Tips
- Always verify if the patient qualifies for the age-based premium (under 16) to ensure the surgeon and assistant fees are increased by the correct percentage.
- Ensure that if the procedure is non-elective and requires travel, you select the correct Special Visit Premium code (e.g., C990, C992) rather than attempting to bill standard after-hours premiums.
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