N266 – Anastomosis hypoglossal or accessory to facial nerve
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
N266 is classified as a surgical procedure under the Neurological Surgery specialty. As a surgical code, it is subject to the general rules for surgery, assistance, and anaesthesia outlined in the Schedule of Benefits.
Payment Structure:
- Surgeon (Suffix A): The fee is for the personal performance of the procedure.
- Surgical Assistant (Suffix B): The fee is calculated based on basic units and time units as described on -. The assistant's unit fee is $12.51.
- Anaesthesiologist (Suffix C): The fee is calculated based on basic units and time units as described on -. The anaesthesiologist's unit fee is $15.49.
This procedure is eligible for various add-on premiums, including those for after-hours service, patient age, and specific anaesthetic complexities. See the addOnEligibleCodes section for details. The specific details of this procedure are not provided in the supplied context.
When to Use
- Use N266 when performing a nerve graft or direct anastomosis to restore facial nerve function following facial nerve paralysis.
- Select N266 specifically for hypoglossal-to-facial or accessory-to-facial nerve transfers, distinguishing it from intracranial nerve repairs coded under different neurological sections.
Common Pitfalls
- Failing to bill E901 alongside N266 is a common revenue loss, as the operating microscope is standard for this microsurgical anastomosis.
- Billing N266 as a primary procedure while simultaneously billing other unrelated neurological procedures may trigger manual review if the global surgical period rules are not respected.
Billing Tips
- Always append E901 to your claim for N266 to capture the additional fee for the use of the operating microscope, as it is specifically designated as an add-on for this code.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Neurological Surgical Procedures
All insured services must be documented in appropriate records.
The medical record must establish that an insured service was provided, the service submitted is the service that was rendered, and the service was medically necessary.
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