N144 – Drainage and/or removal by craniotomy
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
N144 is a fee code for a neurosurgical procedure. As a surgical service, it is subject to general payment rules for procedures, including specific calculations for anaesthesiologist and surgical assistant fees based on basic and time units. The service may be eligible for various premiums, including age-based premiums for patients under 16, after-hours premiums for non-elective procedures, and the trauma premium for severely injured patients. Specific details regarding the nature of this procedure are not provided in the supplied context.
When to Use
- Use N144 for craniotomy procedures involving the drainage of intracranial collections or the removal of lesions where N143 is not the appropriate descriptor.
- Select N144 when the surgical approach requires a craniotomy for access, distinguishing it from burr hole procedures or other less invasive drainage techniques.
Common Pitfalls
- Billing N144 in conjunction with N143 for the same craniotomy procedure will result in an automatic rejection as they are mutually exclusive.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium will lead to recovery of the premium during audit.
- Attempting to bill a second surgical assistant without prior medical consultant authorization, as N144 is not on the pre-approved list for multiple assistants.
Billing Tips
- Ensure the start time of the procedure is accurately recorded to support the application of after-hours premiums (E409, E410) or surgical assistant premiums (E400B, E401B).
- When performing multiple surgical procedures during the same anaesthetic, ensure the basic units for the assistant and anaesthesiologist are derived solely from the major procedure.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Neurological Surgical Procedures
All insured services must be documented in appropriate records to establish that: 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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