M084 – Segmental, including reconstruction
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Segmental laryngectomy, including reconstruction. This surgical procedure involves the partial removal of the larynx. Note: Excision to include laryngoscopy. - Surgeon (Suffix A): The surgical fee includes pre-operative and post-operative care as outlined in the Surgical Preamble (). - Assistant (Suffix B): The fee is calculated using 6 basic units plus time units. See for details. - Anaesthetist (Suffix C): The fee is calculated using 9 basic units plus time units. See for details.
When to Use
- Use M084 for partial laryngectomy procedures that involve formal reconstruction of the laryngeal framework or mucosal defects.
- Use this code when the surgical plan requires a segmental resection of the larynx, specifically noting that the required diagnostic or operative laryngoscopy is included in the fee.
Common Pitfalls
- Do not bill M090 (Laryngoscopy) separately, as the M084 fee explicitly includes the laryngoscopy component.
- Failure to document the specific segmental nature of the resection and the reconstruction technique can lead to audit scrutiny regarding the appropriateness of the code selection versus less complex laryngeal procedures.
- Ensure that the 15% reduction rule is applied if a secondary, lesser procedure is performed by the same surgeon during the same hospitalization within 14 days.
Billing Tips
- If the patient meets the criteria for morbid obesity, ensure the BMI is clearly recorded in the chart to support the addition of E676A for the surgeon or E676B for the assistant.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
Excision to include laryngoscopy.
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