N177 – Sciatic nerve in buttock
OHIP Otolaryngology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the sciatic nerve in the buttock, which may include exploration, decompression, division, excision, biopsy, neurolysis, and/or transposition. This service is listed in both the Musculoskeletal and Neurological sections of the Schedule. Payment for the surgeon (suffix A) is a flat fee. Payment for the assistant (suffix B) and anaesthetist (suffix C) is calculated based on a system of basic units and time units.
When to Use
- Use N177 for surgical exploration or neurolysis of the sciatic nerve specifically within the buttock region.
- Use this code for decompression or excision procedures involving the sciatic nerve when the anatomical focus is the gluteal area.
- Select N177 over N188 or N285 when the procedure is limited to the sciatic nerve in the buttock rather than more distal peripheral nerve sites.
Common Pitfalls
- Billing N177 as a primary procedure when it is incidental to a larger orthopedic procedure, which may lead to audit scrutiny regarding unbundling.
- Failing to document the use of an operating microscope when claiming the E906 premium, which is a common trigger for rejection or recovery.
- Incorrectly applying E925 for routine nerve procedures; this premium is strictly reserved for repeat peripheral nerve surgeries or acute repairs delayed beyond 4 weeks.
Billing Tips
- Always append the E906 premium code to your claim if an operating microscope was utilized, as it provides a 40% increase to the basic fee.
- Ensure that if the procedure is non-elective and performed after hours, you select the appropriate E-series premium (E409 or E410) to maximize the surgeon's fee.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Neurological Surgical Procedures, Musculoskeletal System Surgical Procedures
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