What is OHIP billing code M099?

M099 is "Segmental resection of cervical trachea", an OHIP Ophthalmology code from the Ontario Schedule of Benefits (Physician Services).

How much does M099 pay?

The current OHIP fee for M099 is $918.60, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill M099 to OHIP?

M099 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates M099 claims against the Schedule of Benefits rules before submission.

What codes are related to M099?

Codes related to M099 in the Schedule of Benefits include E623A, E631A, M103, M104, M100, M101.

All codes

M099

M099 – Segmental resection of cervical trachea

OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

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Segmental resection of the cervical trachea is the surgical excision of a portion of the windpipe in the neck. This procedure is typically performed to address conditions such as tracheal stenosis, tumors, or severe trauma. The listed fee includes pre-operative and post-operative care as outlined in the Surgical Preamble (). The anaesthetic benefit is calculated based on 10 base units plus time units (), and the assistant benefit is based on 9 base units plus time units ().

When to Use

Use M099 for the primary surgical excision of a tracheal segment due to benign stenosis or localized tracheal tumors.
Use M099 when performing a formal segmental resection rather than a simple endoscopic dilation or stenting procedure (e.g., M103 or M104).
Use M099 in conjunction with E631A if the surgical plan necessitates the resection of the cricoid cartilage alongside the tracheal segment.

Common Pitfalls

Failure to document the specific BMI in the permanent medical record when claiming the E676A morbidly obese premium, which is a common audit trigger.
Incorrectly billing M099 alongside endoscopic procedures (e.g., bronchoscopy) without applying the 85% reduction rule for multiple procedures performed under the same anaesthesia.
Attempting to claim the E420 trauma premium without explicitly documenting the calculated Injury Severity Score (ISS) in the patient's chart.

Billing Tips

Always verify if the procedure qualifies for the E409A 50% non-elective premium, as tracheal resections for acute stenosis or trauma often meet the criteria for urgent/non-elective status.
Ensure the surgical assistant bills the E676B unit add-on specifically for morbidly obese patients, provided the BMI is documented and the case meets the open-technique requirement.

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Provider Fee$918.60

Surgical Assistant Fee$112.59

Anaesthetist Fee$154.90

Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

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