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N112
N112 – Endonasal endoscopic or microscopic approach for surgical access to sella turcica
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Endonasal endoscopic or microscopic approach for surgical access to sella turcica, performed by a surgeon not rendering resection of the lesion(s). The service includes, when rendered, middle turbinate reductions, maxillary antrostomies, ethmoidotomies, ethmoidectomies, sphenoidotomies, septotomy, septoplasty and septal mucosal flap(s) harvest associated with septotomy or sphenoidal mucosal flap(s).
When to Use
- Use N112 when you perform the endonasal endoscopic or microscopic surgical access to the sella turcica, but a separate surgeon (e.g., a neurosurgeon) performs the actual resection of the lesion.
- Use N112 to capture the work of the access surgeon, which explicitly includes middle turbinate reductions, ethmoidectomies, and sphenoidotomies performed to reach the sella.
Common Pitfalls
- Do not bill any codes from the Respiratory Surgical Procedures or Integumentary System Surgical Procedures sections of the Schedule alongside N112, as these are considered inclusive.
- Avoid billing N112 if you are also the surgeon performing the resection; N112 is specifically restricted to the surgeon who does not render the resection of the lesion(s).
Billing Tips
- If the procedure involves an extended approach to the anterior skull base, clivus, or posterior fossa, ensure you append the E886 add-on code to maximize the claim value.
- Verify that the procedure is non-elective or a delayed elective case to qualify for the E409 or E410 after-hours premiums, as these are not applicable to routine elective scheduling.
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