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M061
M061 – Trans-septal sphenoidectomy for tumour or radical exenteration of disease
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
A trans-septal sphenoidectomy is a surgical intervention for the removal of a tumour or the radical exenteration of disease from the sphenoid sinus. The procedure is performed using a trans-septal approach. Note: M061 is not eligible for payment when rendered for performing the approach to the pituitary fossa as part of N111, N112, N114 or N116.
When to Use
- Use M061 when performing an isolated trans-septal sphenoidectomy for the primary purpose of tumor resection or radical disease exenteration within the sphenoid sinus.
- Use M061 for standalone sphenoid sinus pathology where no pituitary fossa involvement or neurosurgical intervention (N111, N112, N114, N116) is required.
Common Pitfalls
- Billing M061 in conjunction with N111, N112, N114, or N116 is a common cause of automatic rejection, as the approach is considered bundled into the pituitary procedure.
- Attempting to claim M061 as a secondary procedure when performing a pituitary surgery will trigger an audit, as it is explicitly restricted as an approach code for those specific neurosurgical interventions.
Billing Tips
- If performing a sphenoidectomy alongside another non-restricted procedure, ensure the major procedure is billed at 100% and M061 is billed at 85% per the multiple procedure rules.
- Always verify the primary surgical intent; if the sphenoid entry is solely to access the sella turcica for a pituitary tumor, M061 is not payable and the work must be captured within the N-series code.
Provider Fee$355.65
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
Effective: April 1, 2025
Category
P. Respiratory Surgical Procedures
Subcategory
RESPIRATORY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Respiratory Surgical Procedures
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