E341 – Intra-cochlear prosthesis insertion
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
Intra-cochlear insertion of a permanent cochlear prosthesis. As a surgical procedure, this service includes all constituent and common elements, such as pre-operative assessment, the surgical procedure itself, and normal post-operative care. Fees for surgical assistance and anaesthesia are calculated based on basic units plus time units as defined in the Schedule of Benefits.
When to Use
- Use E341 for the primary surgical insertion of a permanent cochlear prosthesis in patients with profound sensorineural hearing loss.
- Use E341 when performing the definitive surgical implantation of the internal device, as opposed to diagnostic or exploratory procedures like E331 or E332.
Common Pitfalls
- Billing E341 in conjunction with other minor ear procedures performed during the same session without accounting for the Schedule of Benefits rules regarding multiple procedure reductions.
- Failing to document the specific device type or surgical approach, which may be required for audit verification of the 'medically necessary' component of the procedure.
Billing Tips
- Ensure the surgical assistant and anaesthesiologist claims correctly utilize the 7 and 9 basic units respectively, as defined in the Schedule of Benefits, to avoid automatic claim adjustments.
- When applicable, confirm the patient's age at the time of the procedure to apply the correct percentage-based age premium (e.g., AGE_PREMIUM_LT16Y) to the procedural fee.
Effective: April 1, 2025
Y. Ocular and Aural Surgical Procedures
Y. Ocular and Aural Surgical Procedures
Surgical
Ocular and Aural Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Payment for surgical assistant (suffix B) services is calculated by adding the 7 basic units to the calculated time units and multiplying the total by the assistant unit fee of $12.51.
Payment for anaesthesiologist (suffix C) services is calculated by adding the 9 basic units to the calculated time units and multiplying the total by the anaesthesiologist unit fee of $15.49.
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