N188 – Minor nerve - including digital, cutaneous or lateral femoral cutaneous nerve
OHIP Otolaryngology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Exploration, decompression, division, excision, biopsy, neurolysis and/or transposition of a minor nerve - including digital, cutaneous or lateral femoral cutaneous nerve.
When to Use
- Use N188 for the surgical release or decompression of the lateral femoral cutaneous nerve in cases of meralgia paresthetica.
- Use N188 for the excision or neurolysis of digital nerves during the management of symptomatic neuromas in the hand or foot.
- Use N188 when performing a biopsy of a cutaneous nerve for diagnostic purposes, provided the procedure meets the definition of a surgical exploration.
Common Pitfalls
- Billing N188 in conjunction with flexor tendon repairs (R585 or E581) through the same incision is prohibited and will result in a nil payment.
- Attempting to bill N188 for simple nerve blocks or diagnostic injections, which are not surgical explorations and should be billed under appropriate anaesthesia or diagnostic codes.
- Failure to document the use of an operating microscope in the operative report, which is a mandatory requirement to successfully claim the E906 40% premium.
Billing Tips
- Always verify if the procedure qualifies for the E906 microscope premium, as it significantly increases the value of this minor nerve code.
- If performing a repeat nerve procedure or a delayed repair (greater than 4 weeks post-injury), ensure the E925 code is appended to capture the 30% increase.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Neurological Surgical Procedures, Musculoskeletal System Surgical Procedures
The medical record must establish that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary, as per .
For time-based components (anaesthesia, assistant), the physician must record the start and end times in the patient's permanent medical record, as per .
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