What is OHIP billing code N269?

N269 is "XI - Division of nerves to sternomastoid in neck", an OHIP Otolaryngology code from the Ontario Schedule of Benefits (Physician Services).

How much does N269 pay?

The current OHIP fee for N269 is $292.25, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill N269 to OHIP?

N269 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates N269 claims against the Schedule of Benefits rules before submission.

All codes

N269

N269 – XI - Division of nerves to sternomastoid in neck

OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits

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N269 is a fee code for a surgical procedure: XI - Division of nerves to sternomastoid in neck, classified under the Neurological Surgical Procedures section. As a surgical service, payment includes the procedure itself (suffix A), as well as services for a surgical assistant (suffix B) and an anaesthesiologist (suffix C) when required. It is also eligible for various premiums, including those for age, after-hours services, and trauma, subject to the rules outlined in the General Preamble of the OHIP Schedule of Benefits.

When to Use

Use N269 for the surgical division of the spinal accessory nerve or its branches to the sternomastoid muscle, typically indicated for the treatment of spasmodic torticollis.
Select N269 when performing a selective peripheral denervation procedure specifically targeting the sternomastoid muscle, distinct from broader cervical rhizotomy procedures.

Common Pitfalls

Do not bill N269 in conjunction with other cervical nerve procedures unless they are distinct, separate anatomical targets; otherwise, they may be considered inclusive under the multiple procedure rules.
Failure to document the specific nerve branches divided can lead to audit scrutiny, as the code is specific to the sternomastoid innervation rather than a general neck exploration.
N269 is a surgical procedure code; billing it alongside a consultation code on the same day requires a diagnostic code that justifies the necessity of both services to avoid rejection.

Billing Tips

Ensure that if N269 is performed bilaterally, you append the appropriate bilateral modifier (e.g., suffix 'B' or 'T' depending on the specific billing software requirements) to ensure correct payment for both sides.
When N269 is performed as part of a multi-stage or complex neurological reconstruction, ensure the primary procedure is listed first to correctly trigger the surgical assistant and anaesthesia unit calculations.

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Provider Fee$292.25

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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