N288 – Nerve graft - major
OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits
A major nerve graft surgical procedure for a mixed sensory and motor nerve, or a pure motor nerve. As per page , payment for this service includes several components if performed: - Exploration, decompression, division, excision, and/or neurolysis of the nerve(s) involved. - Harvesting of the nerve(s) required for grafting. - Any guidance, nerve stimulation, or nerve mapping. An additional fee may be claimed using E899 for each additional cable required for the graft.
When to Use
- Use N288 for the surgical repair of a major mixed sensory and motor nerve or a pure motor nerve involving a graft.
- Use N288 when the procedure requires harvesting of a donor nerve, as the harvesting component is bundled into this fee.
Common Pitfalls
- Do not bill separately for nerve exploration, neurolysis, or nerve stimulation, as these are explicitly bundled into the N288 fee.
- Do not attempt to bill for the harvesting of the graft nerve as a separate procedure, as this is included in the N288 payment.
- Failure to append E899 for additional cables will result in underpayment, as E899 is the only mechanism to claim for multiple cables beyond the base graft.
Billing Tips
- Always document the number of cables used to justify the quantity of E899 units claimed alongside N288.
- Ensure the age of the patient is verified against the age premium schedule, as N288 is eligible for significant percentage increases for patients under 16 years of age.
Effective: April 1, 2025
X. Neurological Surgical Procedures
NEUROLOGICAL SURGICAL PROCEDURES
Surgical
Neurological Surgical Procedures
Payment rules:
1. N188 or N285 when performed through the same incision as flexor tendon repairs `R585` or E581 is an insured service payable at nil.
2. N289, N287, N293, N291, N183 and/or N288 include exploration, decompression, division, excision, and/or neurolysis of the nerve(s) involved, if performed.
3. N293 or N291 are only eligible for payment for coaptation of one or more donor nerve fascicles to a recipient nerve.
4. Nerve graft fees include harvesting of the nerve(s) required for grafting.
5. Peripheral nerve fees codes include any guidance, nerve stimulation, or nerve mapping if performed.
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