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E919
E919 – Intracranial duroplasty
OHIP Surgical Assists Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Intracranial duroplasty (greater than 2 cm diameter) to any intracranial procedure. This code is an add-on to any intracranial procedure.
When to Use
- Use E919 as an add-on to craniotomy codes like S106 or S108 when a dural graft or patch exceeding 2 cm is required for closure.
- Apply this code when performing a duroplasty during complex skull base surgery or tumor resection where the dural defect is significant enough to require a graft larger than 2 cm.
Common Pitfalls
- Billing E919 for dural repairs smaller than 2 cm, which is a common audit trigger for over-billing.
- Attempting to bill E919 as a standalone procedure; it will be rejected unless linked to a primary intracranial surgical procedure code.
- Failing to specify the size of the duroplasty in the operative report, which makes the claim indefensible during a Ministry audit.
Billing Tips
- Ensure the operative note explicitly states 'duroplasty greater than 2 cm' to satisfy the specific requirement for this add-on fee.
- Always link E919 to the primary intracranial procedure code on the same claim submission to ensure the system recognizes it as a valid add-on.
Provider Fee$254.45
Effective: April 1, 2025
Category
X. Neurological Surgical Procedures
Subcategory
NEUROLOGICAL SURGICAL PROCEDURES
Service Type
AddOn
Code Classes
Other Premiums (including After Hours Procedure Premiums)
Documentation of duroplasty greater than 2 cm diameter.
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