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E951
E951 – Corneal transplant - with artificial prosthesis
OHIP Surgical Assists Code — OCULAR SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on code to be billed in addition to E121 (penetrating corneal transplant) when the procedure involves the use of an artificial prosthesis.
When to Use
- Use E951 exclusively as an add-on to E121 when performing a penetrating keratoplasty that requires the insertion of an artificial corneal prosthesis (keratoprosthesis).
- Apply this code when the clinical complexity of the corneal transplant necessitates the use of a synthetic device to maintain ocular integrity or visual function.
Common Pitfalls
- Billing E951 as a standalone procedure code will result in an automatic rejection, as it is strictly an add-on to E121.
- Attempting to bill E951 with other corneal surgery codes (e.g., lamellar keratoplasty) is incorrect; it is specifically linked to the penetrating transplant code E121.
- Failure to link the E951 claim to the E121 service on the same claim submission will lead to payment denial.
Billing Tips
- Ensure the operative report clearly details the specific type of artificial prosthesis used to justify the add-on fee in the event of a post-payment audit.
- When applying age premiums or after-hours premiums (E409/E410), ensure they are calculated based on the combined value of the primary E121 procedure and the E951 add-on where applicable.
Provider Fee$52.40
Effective: April 1, 2025
Category
Y. Ocular and Aural Surgical Procedures
Subcategory
OCULAR SURGICAL PROCEDURES
Service Type
Procedure
Code Classes
Ocular and Aural Surgical Procedures
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