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N203
N203 – Skull tumour, excision
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure. The fee for the surgeon (suffix A) generally includes the major pre-operative assessment, the operation itself, and normal post-operative care. Fees for a surgical assistant (suffix B) and anaesthesiologist (suffix C) are calculated based on basic units and time units as per the rules in the General Preamble (-). Various premiums for age, after-hours services, and trauma may also apply.
When to Use
- Use N203 for the surgical excision of a primary or secondary neoplasm involving the skull vault or base where the procedure is limited to the bone.
- Use this code when the primary objective is the removal of a skull tumour, distinguishing it from intracranial procedures that involve dural opening or brain resection.
Common Pitfalls
- Billing N203 alongside a craniotomy code (e.g., N001) for the same site is often flagged as unbundling; ensure the procedure is distinct and not an incidental part of a larger intracranial surgery.
- Failing to document the specific pathology or the extent of the bone involvement can lead to audit scrutiny regarding the appropriateness of the N203 fee versus a minor excision code.
Billing Tips
- If the excision requires a complex reconstruction or involves significant soft tissue management, ensure your operative report clearly delineates the N203 procedure from any additional reconstructive billing codes to avoid rejection.
Provider Fee$408.30
Surgical Assistant Fee$137.61
Anaesthetist Fee$170.39
Non-Anaesthetist Fee$170.39
Effective: April 1, 2025
Since Apr 2004, this fee has increased 9.2% vs 57.0% CPI inflation
Category
X. Neurological Surgical Procedures
Subcategory
NEUROLOGICAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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