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E957
E957 – Myringoplasty with mastoidectomy
OHIP Surgical Assists Code — Y. Ocular and Aural Surgical Procedures · Schedule of Benefits
This is a surgical add-on code that is payable in addition to the fee for a primary tympanoplasty procedure when a mastoidectomy is also performed. The service is listed under the Middle Ear subsection of Ocular and Aural Surgical Procedures on page of the Schedule.
When to Use
- Use E957 specifically when performing a mastoidectomy in conjunction with a primary tympanoplasty procedure such as E336 or E337.
- Apply this code when the surgical approach requires both the reconstruction of the tympanic membrane and the management of mastoid disease.
Common Pitfalls
- Billing E957 as a standalone procedure will result in rejection, as it is strictly an add-on code that requires a primary tympanoplasty code to be present on the same claim.
- Failing to link the primary procedure and the add-on code on the same claim submission often leads to payment processing errors.
- Billing E957 when only a simple myringoplasty is performed without the mastoidectomy component is an audit risk for upcoding.
Billing Tips
- Ensure the primary procedure (e.g., E336 or E337) is billed as the primary line item to establish the base for the surgical claim before adding E957.
- Verify that the operative report clearly documents the mastoidectomy component to support the use of E957 in the event of a post-payment audit.
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