N148 – Removal of intracerebral haematoma and/or debridement of traumatized brain
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure listed in the Neurological Surgical Procedures section of the Schedule of Benefits. As a surgical procedure, it includes pre-operative, intra-operative, and post-operative care as defined in the General Preamble. The fee is payable to the physician performing the procedure (suffix A). Fees for surgical assistance (suffix B) and anaesthesia (suffix C) are also listed and are calculated based on basic and time units. The procedure includes management of any skull fracture.
When to Use
- Use N148 for the surgical evacuation of a symptomatic intracerebral hematoma, including the necessary debridement of necrotic or traumatized brain tissue.
- Use N148 when performing a craniotomy specifically to address a traumatic brain injury that requires both hematoma evacuation and debridement of damaged parenchyma.
Common Pitfalls
- Attempting to bill N143 or N144 in addition to N148 is a common rejection, as these are mutually exclusive for the same craniotomy procedure.
- Failing to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium, even if the patient meets the clinical criteria for trauma.
Billing Tips
- Ensure the E420 trauma premium is submitted on the same claim as N148, confirming the ISS is explicitly recorded in the operative note to satisfy audit requirements.
- Remember that N148 includes the management of any associated skull fracture; do not bill separate fracture management codes for the same surgical site.
Effective: April 1, 2026
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record 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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