N168 – Lateral canthal advancement - bilateral - two surgeons, major portion
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Lateral canthal advancement - bilateral - two surgeons, major portion. This service is eligible for surgical assistant and anaesthesia services. General payment rules, including those for after-hours work and trauma cases, apply as outlined in the General Preamble.
When to Use
- Use N168 specifically for bilateral lateral canthal advancement procedures where two surgeons are involved and you are the lead surgeon performing the major portion.
- Select this code when the surgical intervention requires a bilateral approach to the lateral canthus to address structural or functional deficits, distinguishing it from unilateral procedures.
Common Pitfalls
- Billing N168 as a single surgeon procedure; this code is explicitly defined for two-surgeon scenarios and will be rejected if the secondary surgeon's claim is not linked or present.
- Failure to document the specific 'major portion' of the procedure performed by the lead surgeon, which is a requirement for justifying the primary fee claim in a two-surgeon billing arrangement.
- Incorrectly applying after-hours premiums (E409/E410) when the procedure was elective and not delayed by an emergency, as N168 is subject to strict General Preamble rules regarding non-elective status.
Billing Tips
- Ensure the secondary surgeon submits their claim using the appropriate assistant or co-surgeon code to avoid reconciliation errors that trigger manual audits of the N168 claim.
- Always verify that the patient's age is correctly recorded to automatically trigger the applicable age-based fee premium (e.g., AGE_PREMIUM_5Y_16Y), as these are additive to the base fee of $614.70.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System 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.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.