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E557
E557 – Medial transnasal canthopexy - when done in conjunction with another procedure
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents an add-on fee payable when a unilateral medial transnasal canthopexy is performed at the same surgical session as another primary procedure. This code should be billed in addition to the primary procedure code.
When to Use
- Use E557 when performing a unilateral medial transnasal canthopexy as an adjunct to a primary orbital or naso-ethmoid fracture repair procedure.
- Use this code when the canthopexy is a secondary, distinct component of a larger reconstructive surgical session, such as during complex mid-face trauma management.
Common Pitfalls
- Billing E557 as a standalone procedure will result in automatic rejection, as it is strictly an add-on code requiring a primary surgical code on the same claim.
- Attempting to bill E557 for bilateral procedures without appropriate modifiers or documentation of two distinct, necessary surgical events often triggers manual review or rejection.
- Confusing E557 with R398; ensure the surgical nature of the transnasal canthopexy is clearly distinguished from other orbital or eyelid procedures to avoid audit flags.
Billing Tips
- Always link E557 to the primary surgical procedure code on the same claim to ensure the system recognizes the add-on relationship.
- If the procedure is performed after hours, ensure the after-hours premium (E409 or E410) is applied to the primary procedure, as E557 follows the primary code's eligibility for these premiums.
Provider Fee$154.00
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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