M017 – Packing for localization of cerebrospinal rhinorrhea
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
M017 is a surgical procedure listed under the P. Respiratory Surgical Procedures section. The fee listed in the Schedule applies to the surgeon performing the procedure (suffix A) and the anaesthesiologist (suffix C). Assistance at surgery (suffix B) is not eligible for payment. As per the Surgical Preamble (-), this fee includes pre-operative and post-operative care. The anaesthesia component is calculated based on a unit system, including basic units and time units, as detailed in the Anaesthesiologists' Services section of the General Preamble ().
When to Use
- Use M017 when performing nasal packing specifically to localize a cerebrospinal fluid (CSF) leak, rather than for routine epistaxis management.
- Use M017 in conjunction with E603 when the localization procedure involves the administration of fluorescein to confirm the site of rhinorrhea.
Common Pitfalls
- Do not attempt to claim an assistant fee (suffix B) for this procedure, as it is explicitly ineligible for payment under the Schedule.
- Avoid billing M017 as a routine nasal packing code for epistaxis, as it is specifically categorized under respiratory surgical procedures for CSF localization.
- Failure to account for the 14-day post-operative care period, which is included in the fee and precludes billing for routine follow-up visits for the same condition.
Billing Tips
- Always append the E603 add-on code to your claim if fluorescein injection was utilized to ensure you receive the additional $50.90 benefit.
- If performing multiple surgical procedures during the same session, ensure the major procedure is billed at 100% and M017 is reduced to 85% if it is the secondary procedure.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Unless otherwise stated, the listed benefits are for unilateral procedures only.
Claims for assisting at surgery should be submitted using the suffix 'B' with the procedural code, and for anaesthesia using the suffix 'C'.
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