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N211
N211 – Removal of orbital tumour
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This service is a neurological surgical procedure involving a craniotomy followed by the removal of an orbital tumour. The fee for this procedure includes the standard constituent and common elements of all insured services as outlined in the Schedule of Benefits (, ). As a surgical service, it includes pre-operative and post-operative care typically associated with the procedure. When performed by a supervising physician with a medical trainee, payment is subject to the rules in the 'Supervision of Postgraduate Medical Trainees' section (-).
When to Use
- Use N211 for the primary surgical excision of an orbital tumour requiring a craniotomy approach.
- Select N211 when the procedure involves intracranial access to reach the orbital pathology, distinguishing it from orbital decompression (N213) or simpler orbital explorations.
Common Pitfalls
- Failure to append E901 when an operating microscope is utilized, as this is a separate flat fee add-on not included in the base N211 fee.
- Incorrectly billing N211 for orbital procedures that do not involve a craniotomy, which may lead to audit recovery if the operative report does not support the intracranial approach.
Billing Tips
- Always verify if the case qualifies for age-based premiums (e.g., patients under 16 years) or after-hours premiums (E409/E410) to maximize the procedural fee, as these are calculated as percentages of the N211 base fee.
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