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M108
M108 – Ligation of thoracic duct
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Ligation of the thoracic duct, which is only payable when performed as the sole surgical procedure. This service may be performed via an open approach or minimally invasive techniques such as thoracoscopy, video-assisted thoracic surgery (VATS), or robotic-assisted surgery. When performed using these minimally invasive techniques, the premium code E683 may be applicable.
When to Use
- Use M108 for the definitive surgical ligation of the thoracic duct to treat chylothorax or chylous ascites.
- Select M108 when the ligation is the only surgical procedure performed during the operative session, as it is strictly restricted to a sole procedure.
Common Pitfalls
- Billing M108 alongside other surgical procedures will result in a rejection, as the code is explicitly restricted to being the sole procedure.
- Failing to append the E683 premium when performing the ligation via VATS or robotic-assisted techniques results in significant under-billing of the 35% premium.
- Attempting to bill M108 for diagnostic explorations or procedures where the duct is not successfully ligated may lead to audit scrutiny regarding the 'sole procedure' requirement.
Billing Tips
- Always verify that no other surgical codes are submitted on the same claim, as the 'sole procedure' restriction is strictly enforced by the Ministry.
- If performing the ligation via a minimally invasive approach, ensure E683 is submitted on the same claim to capture the 35% fee increase.
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