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E960
E960 – Mastoidectomy with ossiculoplasty
OHIP Surgical Assists Code — AURAL SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E960 as an add-on when performing ossicular chain reconstruction (e.g., using a prosthesis or autograft) during a cortical mastoidectomy (E320).
- Use this code when performing ossiculoplasty in conjunction with a modified or radical mastoidectomy (E322) to address conductive hearing loss.
- Use E960 when the ossicular chain is revised or reconstructed during a revision mastoidectomy (E315) procedure.
Common Pitfalls
- Billing E960 as a standalone procedure; it is strictly an add-on code and will be rejected if not submitted with E315, E320, or E322.
- Attempting to bill E960 alongside other middle ear reconstruction codes (e.g., E946) without clear clinical documentation of distinct surgical components, which may trigger an audit for unbundling.
- Failing to ensure the primary mastoidectomy code is the base for the claim, as E960 relies entirely on the successful processing of the primary procedure.
Billing Tips
- Always link E960 to the primary mastoidectomy code on the same claim to ensure the Ministry recognizes the surgical relationship.
- Ensure the operative report explicitly details the ossiculoplasty technique used, as this documentation is essential to justify the E960 add-on during a post-payment review.
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