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E940

E940Anterior vitrectomy

OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits

Anterior vitrectomy by corneal or pars plana approach, when done in conjunction with another intraocular procedure

When to Use

  • Use E940 when an anterior vitrectomy is required to manage vitreous prolapse during a primary intraocular procedure, such as a complicated cataract extraction.
  • Use this code when performing a planned anterior vitrectomy via a pars plana or limbal approach that is secondary to the primary surgical intervention.

Common Pitfalls

  • Billing E940 as a standalone procedure will result in automatic rejection, as it is strictly an add-on code requiring a primary intraocular procedure on the same claim.
  • Attempting to bill E940 alongside E142 or E148 will trigger a rejection due to explicit same-day billing restrictions.
  • Failure to clearly document the necessity of the vitrectomy in the operative report poses a significant audit risk, as it must be justified as an adjunct to the primary surgery.

Billing Tips

  • Ensure the primary intraocular procedure is billed on the same claim to satisfy the requirement that E940 is only payable in conjunction with another procedure.
Provider Fee$105.00

Effective: April 1, 2025

Category

Y. Ocular and Aural Surgical Procedures

Subcategory

OCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Ocular and Aural Surgical Procedures

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