M090 – Laryngoplasty
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Laryngoplasty is a surgical procedure for repairing the larynx, for example, due to stenosis, fractures, or transections. This service is not to be billed with M084. As per the surgical preamble on page (PDF page ), the fee for this procedure includes pre-operative care for 1-2 days before surgery and post-operative care for up to two weeks following surgery. However, the first two post-operative visits and the discharge day visit (C124) are payable separately.
When to Use
- Use M090 for surgical reconstruction of the larynx necessitated by traumatic transection or fracture.
- Use M090 for definitive surgical repair of laryngeal stenosis when the procedure involves structural reconstruction rather than simple endoscopic dilation.
- Use M090 for open surgical procedures on the larynx, ensuring it is not billed concurrently with M084.
Common Pitfalls
- Billing for routine post-operative follow-up visits within the 14-day post-op period, as these are included in the global fee; only the first two post-op visits and the discharge day visit (C124) are exempt.
- Attempting to bill M090 alongside M084, which is explicitly prohibited by the Schedule of Benefits.
- Failing to document the BMI in the permanent medical record when claiming the E676A morbid obesity premium, which is a common trigger for audit recovery.
Billing Tips
- Ensure the decision-to-operate consultation or assessment is billed separately from the M090 procedure fee, as the global surgical fee only covers pre-operative care starting 1-2 days before the surgery.
- When performing multiple procedures under the same anaesthetic, remember that M090 is paid at 100% as the major procedure, while subsequent procedures are subject to the 85% rule.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
not to be billed with M084
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