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M014 – Septorhinoplasty

OHIP Respiratory Surgical Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

Septorhinoplasty, listed under Respiratory Surgical Procedures, Nose, Reconstruction. The Schedule lists 6 assistant units and 10 anaesthesia units. Add-ons to M014: E841 (autologous bone or cartilage graft from site(s) other than the nose, to a maximum of two), E842 (non-autologous graft or implant), E642 (external approach using transverse columellar and rim incisions with elevation of the nasal tip skin flap) and E840 (repair of septal perforation). M014 requires written prior authorization by a Ministry of Health medical consultant (see Surgical Preamble, paragraph 17).
Referral requiredFrom: NotApplicablePre-authorization required
Medical records 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 as per .
For services supervised under a medical trainee, specific documentation is required, including identification of the supervising physician, the trainee, a description of the service, patient consent, and evidence of supervision as per .
Written prior authorization by a Ministry of Health medical consultant is required. (Exact documentation requirements from Surgical Preamble, paragraph 17 could not be retrieved as the page/paragraph was not found).

The listed benefits are for unilateral procedures only, unless otherwise stated ().

If a physician performs a minor surgical procedure and during the same visit assesses and treats the patient for another completely unrelated and significant problem involving another body system, the physician should claim for the procedure as well as the appropriate assessment ().

The listed benefit for a procedure normally includes repair of any iatrogenic complications occurring during the course of the surgery performed by the same surgeon ().

If the operation is cancelled after surgery has commenced but prior to its completion, the service is eligible for payment under independent consideration (R990).

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