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E892

E892Harvesting of pedicled vascular flap(s) greater than 3cm in size for use in complex endoscopic closure, repair and/or reconstruction of surgical defect(s)

OHIP Surgical Assists Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits

Harvesting of pedicled vascular flap(s) greater than 3cm in size for use in complex endoscopic closure, repair and/or reconstruction of surgical defect(s). This service is an add-on to N111, N112, N114 or N116. A complex closure is defined as one for a lesion extending beyond the sella turcica, necessary for repair of CSF leak(s), and requiring a pedicled vascular flap greater than 3 cm in size.

When to Use

  • Use E892 when performing a nasoseptal flap harvest greater than 3cm specifically to address a high-flow CSF leak during an endoscopic skull base procedure.
  • Use E892 when the surgical defect involves an expanded endonasal approach extending beyond the sella turcica, such as a planum sphenoidale or clival defect, requiring a robust vascularized pedicled flap.

Common Pitfalls

  • Billing E892 for standard endoscopic procedures where the flap size is less than 3cm or the defect is limited to the sella; these are considered included in the base codes N111, N112, N114, or N116.
  • Submitting E892 without a corresponding base code (N111, N112, N114, or N116) on the same claim, which will result in an automatic rejection.
  • Failing to explicitly document the flap dimensions and the anatomical extent of the lesion beyond the sella, which are mandatory criteria for audit compliance.

Billing Tips

  • Ensure your operative report clearly states the pedicled flap dimensions exceed 3cm and confirms the presence of a CSF leak to satisfy the specific requirements for this add-on code.
  • If performing a complex reconstruction that involves both a pedicled flap and additional free graft materials, ensure you are not double-billing for components already bundled into the primary N-series surgical code.
Provider Fee$500.00

Effective: April 1, 2025

Since Oct 2010, this fee has increased 0.0% vs 39.2% CPI inflation
Category

X. Neurological Surgical Procedures

Subcategory

NEUROLOGICAL SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Neurological Surgical Procedures

A complex closure, repair and/or reconstruction is defined as surgical closure, repair and/or reconstruction: - a. for a lesion extending beyond the sella turcica; and - b. is necessary for repair of CSF leak(s); and - c. requires the use of pedicled vascular flap(s) greater than 3 cm in size.

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