What is OHIP billing code E831?

E831 is "Use of skin grafts or revision surgery", an OHIP Surgical Assists code from the Ontario Schedule of Benefits (Physician Services).

How much does E831 pay?

E831 is a percentage premium: it adds 30% to the fee of the eligible service it is billed with, per the Ontario Schedule of Benefits.

How do I bill E831 to OHIP?

E831 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates E831 claims against the Schedule of Benefits rules before submission.

What codes are related to E831?

Codes related to E831 in the Schedule of Benefits include R549, R551, E832, R576.

All codes

E831

E831 – Use of skin grafts or revision surgery

OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This is a premium indicating the use of skin grafts, or revision surgery (with or without skin grafts), applicable to the following procedures: - R549: Excision of ganglion - R551: Excision of fascia for Dupuytren's (palmar fibromatosis), single ray This service adds 30% to the fee of the primary procedure.

When to Use

Use E831 when performing an R551 procedure that requires a skin graft to close a defect created by the excision of the palmar fascia.
Apply E831 when performing a revision surgery for a recurrent Dupuytren's contracture (R551) where the surgical complexity is increased due to prior scarring or the need for tissue rearrangement.
Use E831 when excising a complex ganglion (R549) that necessitates a skin graft due to inadequate local tissue for primary closure.

Common Pitfalls

Billing E831 alongside codes from the 'Skin Flaps and Grafts' section of the Schedule of Benefits will result in a rejection due to explicit restriction notes.
Claiming E831 for R551 without documenting the specific physical signs required, such as a 30-degree MCP flexion contracture, creates a significant audit risk.
Attempting to bill E831 for routine primary closures of R549 or R551 is an incorrect use of this premium, as it is strictly intended for grafts or revision scenarios.

Billing Tips

Ensure the operative report explicitly details the use of a skin graft or the revision nature of the procedure to support the 30% premium claim.
When billing R551 with E831, ensure the clinical notes clearly state the degree of contracture or the recurrent nature of the disease to satisfy the specific patient condition requirements.

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Percentage Premium: 0.3%

This code applies a percentage increase to the base procedure fee

Provider Fee$0.01

Effective: July 1, 2013

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