M151 – Bullectomy for major bullous disease
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Bullectomy for major bullous disease is an operative procedure involving the excision of large, air-filled sacs (bullae) from the lung. This procedure is intended to improve respiratory function in patients with significant bullous emphysema. The surgeon's fee for M151A includes pre-operative care 1-2 days before surgery and post-operative care for up to two weeks, as outlined in the Surgical Preamble (). The anaesthetist service (M151C) has 13 base units and the assistant service (M151B) has 10 base units; both are eligible for time units as per and .
When to Use
- Use M151A for the surgical excision of large, symptomatic bullae in patients with bullous emphysema where the primary goal is the reduction of lung volume to improve respiratory mechanics.
- Select M151A when performing a formal bullectomy, distinguishing it from simple lung biopsy (e.g., Z338) or minor wedge resections that do not target major bullous disease.
Common Pitfalls
- Billing for pre-operative hospital visits occurring 1-2 days prior to the surgery is a violation of the surgical fee inclusion rules; these are already bundled into the M151A fee.
- Failing to apply the 35% E683 premium when the bullectomy is performed via VATS or robotic approach results in significant under-billing, as this is not automatically triggered by the base code.
- Attempting to bill for routine post-operative care within the 14-day global period, ignoring the specific exception that allows for the first and second post-operative visits to be claimed separately.
Billing Tips
- Ensure that the first and second post-operative visits are billed using the appropriate subsequent visit fee code, as these are explicitly excluded from the 14-day global fee inclusion.
- When performing a bilateral bullectomy, remember that the second procedure is subject to the multiple procedure payment rule (85% of the listed benefit) as per the Surgical Preamble.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
The surgical fee includes pre-operative hospital visits which take place 1 or 2 days prior to surgery.
The surgical fee includes post-operative care and visits associated with the procedure for up to two weeks post-operatively, except for the first and second post-operative visits (payable at the specialty specific subsequent visit fee) and the subsequent visit by the MRP - day of discharge (C124).
Unless otherwise stated, the listed benefit is for a unilateral procedure. Bilateral procedures are subject to the multiple procedures payment rule.
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