N200 – Decompressive craniectomy
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
N200 represents a surgical procedure within the Neurological Surgical Procedures section of the OHIP Schedule of Benefits. Payment rules for surgical procedures, including assistant and anaesthetist services, are outlined in the General Preamble. The fee for the surgeon is claimed with suffix A. Surgical assistance is claimed with suffix B, and anaesthesia services with suffix C, as per . The fees for assistant and anaesthesia services are calculated based on basic units and time units.
When to Use
- Use N200 for a formal decompressive craniectomy performed to manage refractory intracranial hypertension or space-occupying lesions.
- Select N200 when the surgical intent is the removal of a significant portion of the skull to allow for brain expansion, distinguishing it from simple burr hole procedures or craniotomies for tumor resection.
Common Pitfalls
- Billing N200 alongside N153 without a manual review indicator and supporting operative notes will result in automatic rejection or audit flags.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium for N200 will lead to recovery of the premium during audit.
Billing Tips
- Ensure the surgical start time is clearly recorded, as this is the definitive trigger for applying after-hours (E409) or night (E410) premiums for the surgeon, and corresponding assistant/anaesthesia premiums.
Effective: April 1, 2026
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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