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E956
E956 – Meatoplasty or canalplasty - with tympanoplasty and/or ossiculoplasty, and/or mastoidectomy
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
This is an add-on fee code for the surgeon, payable in addition to E314 (Meatoplasty or canalplasty for congenital malformation) when the procedure also includes tympanoplasty and/or ossiculoplasty, and/or mastoidectomy. The anaesthetist fee is also an add-on, payable in addition to the anaesthesia for the primary procedure.
When to Use
- Use E956 as an add-on when performing a tympanoplasty or ossiculoplasty in conjunction with a meatoplasty or canalplasty for congenital aural atresia (E314).
- Use E956 when a mastoidectomy is required as part of the surgical approach for a congenital canal reconstruction billed under E314.
Common Pitfalls
- Billing E956 as a standalone procedure; it is strictly an add-on code and will be rejected if not submitted with the primary E314 procedure.
- Attempting to bill E956 for acquired ear canal stenosis or non-congenital pathologies, as the primary code E314 is specific to congenital malformations.
Billing Tips
- Ensure the primary procedure E314 is billed on the same claim to trigger the payment for the E956 add-on.
- Apply relevant age-based premiums (e.g., AGE_PREMIUM_UNDER_16) to the total surgical fee, as E956 is eligible for these percentage increases when the patient meets the criteria.
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