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N164
N164 – Lateral canthal advancement - one surgeon
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure within the Neurological Surgical Procedures section of the Schedule of Benefits. Payment is made for the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) according to the rules outlined in the General Preamble. The specific elements of surgical assistance are detailed on , and for anaesthesia on .
When to Use
- Use N164 for the surgical correction of orbital dystopia or lateral orbital wall advancement in craniosynostosis cases.
- Select N164 when performing a unilateral lateral canthal advancement as a primary neurological surgical procedure.
Common Pitfalls
- Billing N164 alongside other cranial vault remodeling codes without ensuring they are not considered 'incidental' or 'included' under the General Preamble rules for multiple procedures.
- Failing to document the specific lateral canthal advancement separate from broader craniosynostosis repairs, which can lead to audit scrutiny regarding unbundling.
Billing Tips
- Ensure the age-based fee premiums are correctly applied, as pediatric patients undergoing this procedure are frequently eligible for the 10% to 30% increases depending on their exact age.
- If performing bilateral procedures, remember that the assistant and anaesthetist basic units are calculated based on the major procedure only, per the payment adjustment rules.
Provider Fee$696.35
Surgical Assistant Fee$187.65
Anaesthetist Fee$232.35
Non-Anaesthetist Fee$232.35
Effective: April 1, 2025
Category
X. Neurological Surgical Procedures
Subcategory
NEUROLOGICAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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