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N291

N291Nerve transfer - major

OHIP Otolaryngology Code — NEUROLOGICAL SURGICAL PROCEDURES · Schedule of Benefits

Surgical transfer of a major nerve, defined as a mixed sensory and motor nerve, or a pure motor nerve.

When to Use

  • Use N291 for the transfer of a major nerve, such as a motor or mixed sensory-motor nerve, to restore function in cases of significant nerve injury or palsy.
  • Select N291 when performing a nerve transfer that involves a donor nerve of significant caliber, distinguishing it from minor nerve repairs or neurolysis (e.g., N188 or N285).

Common Pitfalls

  • Failing to document the use of an operating microscope prevents the application of the E906 40% premium, which is standard for these microsurgical procedures.
  • Incorrectly billing N291 for minor nerve procedures or simple neurolysis; ensure the procedure meets the definition of a 'major' nerve transfer to avoid audit recovery.

Billing Tips

  • Always append E906 to N291 when an operating microscope is utilized to capture the 40% fee increase.
  • If the nerve transfer is performed more than 4 weeks after an acute injury, ensure E925 is submitted to claim the 30% delay premium.
Provider Fee$841.75
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76

Effective: April 1, 2026

Category

X. Neurological Surgical Procedures

Subcategory

NEUROLOGICAL SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Neurological Surgical Procedures

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