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E955
E955 – Meatoplasty or canalplasty - with grafting of canal
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
This is an add-on code to be billed in conjunction with E314 (Meatoplasty or canalplasty for congenital malformation). This code represents the additional procedure of grafting the canal during the meatoplasty/canalplasty. The anaesthesia for this component adds to the time calculation for the primary procedure's anaesthesia service.
When to Use
- Use E955 only when a split-thickness or full-thickness skin graft is harvested and applied to the ear canal during an E314 meatoplasty or canalplasty procedure.
- Apply this code when the surgical documentation explicitly describes the harvesting and placement of a graft to line the canal, distinguishing it from a simple meatoplasty without grafting.
Common Pitfalls
- Billing E955 as a standalone procedure will result in an automatic rejection, as it must be submitted on the same claim as E314.
- Submitting E955 without clear operative notes detailing the graft harvest site and the specific canal reconstruction technique is a high audit risk for unbundling or incorrect coding.
Billing Tips
- Ensure the primary procedure E314 is billed on the same claim; E955 is strictly an add-on code and cannot be paid in isolation.
- If the patient qualifies for age-based premiums, ensure they are applied to the total surgical fee, including the E955 add-on, to maximize the procedural reimbursement.
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