N139 – Reduction of skull fracture - simple, depressed
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
N139 is a surgical procedure listed under the Neurological Surgical Procedures section of the Schedule of Benefits. The specific description and required elements for this procedure are not available in the provided context. As a surgical procedure, it is subject to the general rules for surgery, including the use of suffixes 'A' for the surgeon, 'B' for the assistant, and 'C' for the anaesthesiologist as described on .
When to Use
- Use N139 for the surgical elevation of a simple, depressed skull fracture that does not involve dural involvement.
- Use N139 in conjunction with E912 if the procedure reveals and requires the repair of a dural laceration during the reduction.
Common Pitfalls
- Billing N139 without documenting the specific nature of the fracture as 'depressed' can lead to audit scrutiny regarding the necessity of the surgical intervention.
- Failing to include the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium for this procedure will result in automatic rejection.
Billing Tips
- Always verify if the procedure qualifies for the E420 trauma premium by confirming the ISS threshold (greater than 15 for adults, greater than 12 for pediatrics) and ensuring the service occurs within 24 hours of the injury.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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