N207 – Craniosynostosis, multiple sutures
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Craniosynostosis, multiple sutures. This is a surgical procedure within the Neurological Surgical Procedures section of the Schedule. The service can be billed by the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C), with fees calculated based on rules in the General Preamble. Various premiums may apply based on patient age, time of day, and clinical circumstances.
When to Use
- Use N207 for the surgical correction of craniosynostosis involving two or more cranial sutures, such as bicoronal or multisutural synostosis.
- Select N207 when the procedure involves complex cranial vault remodeling that exceeds the scope of a single-suture repair.
Common Pitfalls
- Billing N207 alongside other cranial vault procedures without checking for Schedule of Benefits bundling rules, which may lead to automatic claim rejection for unbundling.
- Failing to apply the correct age-based premium (e.g., the 30% increase for patients under 30 days) to both the surgeon (suffix A) and the assistant (suffix B) claims.
Billing Tips
- Always verify the patient's exact age in days at the time of the procedure to ensure the correct percentage-based age premium is applied to the base fee.
- Ensure the operative note explicitly details the specific sutures involved to justify the use of N207 over single-suture codes.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to establish that the service was provided, is the service submitted for payment, and was medically necessary, as per the Health Insurance Act. See .
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