N140 – Reduction of skull fracture - compound
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Represents a surgical procedure on the musculoskeletal system. The fee for the surgeon is a flat rate. The fees for the assistant and anaesthetist are calculated using a unit-based system, combining basic units (specific to the procedure) and time units. For detailed applicability and specific anatomical location, refer to the Musculoskeletal System section of the OHIP Schedule of Benefits.
When to Use
- Use N140 specifically for the surgical reduction of a compound skull fracture where there is an open communication between the fracture site and the external environment.
- Do not use N140 for simple or closed skull fractures; those cases typically fall under different neurological surgical codes or non-surgical management codes.
Common Pitfalls
- Billing N140 alongside other cranial procedures without checking for the 'multiple procedure' rule, which limits the assistant and anaesthetist units to the major procedure only.
- Failing to apply the E420 trauma premium when the procedure is performed in an emergency context, as N140 is a qualifying surgical service for this 50% increase.
Billing Tips
- Ensure the surgical report clearly describes the 'compound' nature of the fracture to justify the use of N140 over simpler fracture management codes during a potential audit.
Effective: April 1, 2026
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The service must be rendered personally by the physician or a supervised medical trainee.
The fee for the surgeon (suffix A) is a flat fee. Fees for the assistant (suffix B) and anaesthetist (suffix C) are calculated based on a combination of basic units and time units.
Surgical services include common and specific elements as defined in the General Preamble, including pre-operative and post-operative care components.
When a surgical procedure is delegated to a Clinical Fellow with an OHIP billing number, the procedure is eligible for payment to the Clinical Fellow as a surgical assistant (suffix B), while the Supervising Physician claims as the operating surgeon (suffix A).
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.