E337 – Myringoplasty with ossiculoplasty
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
Performs a tympanoplasty (surgical repair of the eardrum), which is an extension of E336 (Type 1 tympanoplasty with exploration of middle ear), by additionally performing an ossiculoplasty (reconstruction of the middle ear bones). This is a surgical procedure listed under the Ocular and Aural Surgical Procedures section. Add-on codes such as E957 for mastoidectomy or E959 for meatoplasty/canalplasty may be billed in addition if performed. This service is eligible for various premiums including those for after-hours service, age, and trauma, as well as specific extra units for anaesthesia based on patient-specific factors.
When to Use
- Use E337 when performing a tympanoplasty that includes the reconstruction of the middle ear ossicles, distinguishing it from the simpler E336 which is limited to tympanoplasty and middle ear exploration.
- Use E337 as the primary procedure code when concurrent ossiculoplasty is performed, even if additional procedures like mastoidectomy (E957) or meatoplasty (E959) are also completed during the same operative session.
Common Pitfalls
- Billing E337 and E336 together is a common error; E337 is an extension of E336 and includes the middle ear exploration, making E336 redundant.
- Failure to obtain prior authorization for a surgical assistant (M400B) will result in automatic rejection, as this procedure requires a letter from the surgeon justifying the need for assistance.
- Omitting the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium will lead to audit recovery, as this is a mandatory documentation requirement.
Billing Tips
- Ensure that add-on codes E957 and E959 are submitted on the same claim as E337 to ensure correct processing of the flat fee additions.
- When billing for an assistant, ensure the claim is submitted under M400B and that the surgeon's justification letter is prepared for the medical consultant's review.
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