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N282
N282 – Brachial plexus (excluding excision of cervical and/or first rib and scalenotomy)
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
This surgical procedure involves the brachial plexus and includes one or more of the following components: exploration, decompression, division, excision, biopsy, neurolysis, and/or transposition. It is distinct from and excludes the surgical management of thoracic outlet syndrome or a cervical rib, which are covered under billing code N283.
When to Use
- Use N282 for primary exploration, decompression, or neurolysis of the brachial plexus when the pathology is unrelated to thoracic outlet syndrome or cervical rib.
- Use N282 for brachial plexus biopsy or nerve transposition procedures that do not involve the resection of the first rib or scalenotomy.
- Use N282 in conjunction with N283 only when a complete brachial plexus neurolysis is performed as a distinct, separate component alongside the excision of a cervical rib or first rib.
Common Pitfalls
- Billing N282 for thoracic outlet syndrome or cervical rib decompression will result in automatic rejection; use N283 for these specific indications.
- Failing to document the use of an operating microscope will lead to the denial of the E906 40% premium, which is otherwise applicable to N282.
- Attempting to bill for a second surgical assistant without prior authorization from a medical consultant is a common cause of claim adjustment, as N282 is not on the pre-approved list for second assistants.
Billing Tips
- Always append the E906 premium if an operating microscope is utilized, as N282 is explicitly eligible for this 40% increase for neurolysis and nerve-related procedures.
- If the procedure is a repeat peripheral nerve intervention or involves an acute nerve injury repair delayed by more than four weeks, ensure the E925 30% premium is applied to the base fee.
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