N190 – Exploration and/or decompression and/or neurolysis of ulnar nerve (elbow)
OHIP Otolaryngology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the exploration and/or decompression and/or neurolysis of the ulnar nerve at the elbow. This procedure falls under the category of exploration, decompression, division, excision, biopsy, neurolysis and/or transposition of peripheral nerves. This service may be eligible for premiums such as for use of an operating microscope (E906) or for repeat/delayed procedures (E925).
When to Use
- Use N190 for primary surgical decompression of the ulnar nerve at the elbow (cubital tunnel release) when performed as a standalone procedure.
- Use N190 for neurolysis of the ulnar nerve at the elbow when the nerve is being freed from surrounding scar tissue or adhesions.
Common Pitfalls
- Billing N190 in conjunction with N189 (transposition of the ulnar nerve) is generally considered unbundling; ensure you are not billing for both if the transposition was the primary intent of the procedure.
- Failure to document the use of an operating microscope in the operative report will lead to the rejection of the E906 add-on premium.
- Billing E925 for a repeat procedure without clear documentation in the operative note that this is a revision of a previously failed decompression at the same site.
Billing Tips
- Always append E906 to your N190 claim if you utilized an operating microscope, as this provides a 40% increase to the base fee.
- If the procedure is a revision of a previous cubital tunnel release, ensure the E925 premium is included to capture the 30% increase for repeat peripheral nerve surgery.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Neurological Surgical Procedures, Musculoskeletal System Surgical Procedures
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