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N168

N168Lateral 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.
Provider Fee$614.70
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

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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