M010 – Excision of intranasal lesions by lateral rhinotomy approach
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
M010 is a surgical procedure for the excision of intranasal lesions using a lateral rhinotomy approach.
As a surgical procedure, the fee includes pre-operative and post-operative care as outlined in the Surgical Preamble (:529-530). The major pre-operative visit where the decision to operate is made is claimed separately as a consultation or assessment.
Anaesthesia: The service has a base unit value of 7 for anaesthesia (Anae). The total anaesthesia fee is calculated by adding time units to these base units and multiplying by the unit fee as described in the General Preamble (:106, :107).
Assistant: The service has a base unit value of 6 for a surgical assistant (Asst). The total assistant fee is calculated by adding time units to these base units and multiplying by the unit fee as described in the General Preamble (:99, :100).
See also M011 for excision of other intranasal lesions (I.C.).
When to Use
- Use M010 specifically for the excision of intranasal lesions requiring a lateral rhinotomy approach, which provides the necessary external exposure for large or complex tumors.
- Use M010 when the procedure involves an external incision along the lateral aspect of the nose, distinguishing it from endoscopic or endonasal approaches that would fall under M011.
Common Pitfalls
- Billing M010 alongside M011 for the same lesion is a common error; M010 is a specific surgical code and should not be unbundled if the approach is singular.
- Failing to bill the initial consultation or assessment separately; M010 is a surgical procedure code and does not include the pre-operative decision-making visit.
Billing Tips
- Ensure the operative report explicitly describes the lateral rhinotomy approach to justify the use of M010 over the I.C. code M011, as this is the primary audit differentiator.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
All insured services must be documented in appropriate records. The record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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