N154 – Vertebrobasilar circulation, including aneurysm of vein of Galen
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
N154 is a surgical procedure listed in the Musculoskeletal System section of the OHIP Schedule of Benefits. As a surgical procedure, it includes all common elements of insured services outlined on -. Surgical Service (Suffix A): The fee for the primary surgeon includes the surgical procedure itself, as well as pre-operative and post-operative care as defined in the surgical preamble. Surgical Assistant Service (Suffix B): Payment for a surgical assistant is calculated based on basic units and time units as per -. It includes specific elements such as patient preparation and post-procedure monitoring. Anaesthesiologist Service (Suffix C): Payment for anaesthesia is calculated based on basic units and time units as per -. The service includes pre-anaesthetic evaluation, the anaesthetic procedure, and post-anaesthetic follow-up. Various premiums may be applicable, including age-based premiums (), after-hours premiums (, , ), and the trauma premium (). Anaesthesia services may also be eligible for extra units based on patient condition ().
When to Use
- Use N154 for the surgical management of vertebrobasilar circulation pathologies, specifically including the repair of an aneurysm of the vein of Galen.
- Select N154 when performing complex neurosurgical interventions involving the posterior circulation that fall under the specific anatomical criteria defined for this procedure.
Common Pitfalls
- Failing to bill E908 as an add-on code when a concomitant intracerebral or subdural haematoma is evacuated during the same operative session.
- Attempting to bill N154 in conjunction with other intracranial aneurysm codes; ensure the procedure strictly aligns with the vertebrobasilar or vein of Galen criteria to avoid rejection for duplicate service.
Billing Tips
- Always verify if the case qualifies for the trauma premium (GP109) if the procedure is performed under emergency trauma conditions, as this is a high-acuity neurosurgical intervention.
Effective: April 1, 2026
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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