N286 – Tumour or neuroma - major nerve
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for the excision of a tumour or neuroma affecting a major nerve. This procedure is eligible for suffix A (surgeon), B (assistant), and C (anaesthetist). The fee for the surgical assistant (suffix B) and anaesthetist (suffix C) is calculated based on a combination of basic units and time units. See 'Unit Based Information' for details. This service may be eligible for several add-on codes and premiums, including: - E906: Add 40% to the basic surgical fee when using an operating microscope. - E925: Add 30% to the basic surgical fee for a repeat peripheral nerve procedure. - E911: Add 40% to the fee for N286 if it includes the implantation of the neuroma into bone or muscle. - Age-based premiums for patients under 16 years of age (see ). - After-hours premiums for surgeon (E409, E410), assistant (E400B, E401B), and anaesthetist (E400C, E401C). - Special visit premiums for assistant and anaesthetist. - Trauma premium (E420) for qualifying patients. - Extra units for anaesthesia based on patient age, BMI, position, ASA status, or other factors (see ).
When to Use
- Use N286 for the surgical excision of a primary tumour or symptomatic neuroma specifically involving a major nerve trunk, such as the sciatic, femoral, or brachial plexus.
- Use N286 when the procedure involves the formal implantation of a neuroma into muscle or bone to prevent recurrence, which allows for the additional E911 premium.
Common Pitfalls
- Do not use N286 for excision of small cutaneous or subcutaneous nerve tumours; these should be billed under N295.
- Avoid billing E906 if the operating microscope was not utilized; audit recovery is common for unsubstantiated microscope claims.
- Failing to document the specific nerve involved or the rationale for a repeat procedure (E925) often leads to manual review or rejection.
Billing Tips
- Always append E911 to the N286 claim if the neuroma was implanted into bone or muscle, as this is a distinct 40% increase that is frequently missed.
- Ensure E925 is only applied for repeat procedures on the same nerve or for acute nerve repairs delayed beyond four weeks, as it is strictly audited against patient history.
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