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E945
E945 – Entropion - repeat
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E945 when you are the second surgeon performing a repeat repair of an entropion that was previously attempted by another surgeon.
- Use E945 when performing a repeat ectropion repair as a second surgeon in conjunction with the primary code E197.
- Use this code specifically when the clinical documentation confirms the procedure is a revision or repeat of a prior failed surgical correction.
Common Pitfalls
- Billing E945 as a standalone code; it will be rejected unless submitted with a primary procedure code of E196 or E197.
- Failure to document the specific rationale for a repeat procedure, which is required for audit compliance under Y9:763.
- Confusing E945 with other surgical add-ons; ensure you are not billing it for a primary procedure, as it is strictly for repeat interventions.
Billing Tips
- Always link E945 to the primary procedure (E196 or E197) on the same claim to ensure the add-on fee is processed correctly.
- Ensure the operative report clearly distinguishes the repeat nature of the surgery to justify the use of this specific add-on code.
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