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N174
N174 – Conversion of shunt
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This service describes the conversion of a cerebrospinal fluid (CSF) shunt, such as from a ventriculoperitoneal to a ventriculoatrial shunt. The procedure explicitly includes the removal of the existing shunt. This service is subject to the general rules for surgery, anaesthesia, and surgical assistance as outlined in the General Preamble of the Schedule of Benefits.
When to Use
- Use N174 when performing a complete conversion of a CSF shunt system, such as transitioning a patient from a ventriculoperitoneal to a ventriculoatrial shunt.
- Apply this code when the procedure specifically necessitates the removal of the existing shunt hardware in conjunction with the placement of the new shunt system.
Common Pitfalls
- Do not bill N174 for simple shunt revisions or repairs; it is strictly intended for the conversion of the shunt type.
- Avoid unbundling the removal of the existing shunt, as the code description explicitly states that removal is included in the fee.
- Ensure the procedure is not miscoded as a primary shunt insertion, as N174 accounts for the complexity of the conversion process.
Billing Tips
- Ensure that the operative report clearly documents the conversion type and the removal of the previous hardware to support the use of N174 over standard insertion codes.
- Verify that all applicable age-based premiums are applied to the surgeon's fee, as these are significant percentage increases for pediatric patients.
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