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N118
N118 – Endovascular approach for dural arteriovenous fistula
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Endovascular approach to include balloon catheter or embolization techniques for dural arteriovenous fistula including carotid cavernous fistula.
When to Use
- Use N118 for endovascular embolization of a dural arteriovenous fistula (dAVF) involving transarterial or transvenous access.
- Use N118 specifically for carotid cavernous fistula (CCF) treatments performed via endovascular balloon or coil embolization techniques.
- Use N118 when the primary procedural intent is the obliteration of the fistula shunt using endovascular catheter-based interventions.
Common Pitfalls
- Do not bill N118 in conjunction with N108 or N125 for the same vascular territory, as this is considered unbundling of the endovascular approach.
- Avoid billing N118 for diagnostic cerebral angiography; diagnostic imaging must be billed separately using the appropriate diagnostic codes if performed prior to the intervention.
- Failure to document the specific embolic agents or balloon techniques used can lead to audit scrutiny regarding the complexity of the procedure.
Billing Tips
- Ensure the surgical assistant (suffix B) and anaesthesia (suffix C) units are calculated based on the 15 basic units plus time units as specified in the Schedule of Benefits.
- If the procedure is performed on an emergent, non-elective basis after hours, ensure the appropriate E-series premium (E409 or E410) is appended to the N118 claim to maximize the procedural fee.
Provider Fee$952.05
Surgical Assistant Fee$187.65
Anaesthetist Fee$232.35
Non-Anaesthetist Fee$232.35
Effective: April 1, 2025
Category
X. Neurological Surgical Procedures
Subcategory
NEUROLOGICAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Neurological Surgical Procedures
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