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N542
N542 – Sympathectomy - unilateral - cervical
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
Unilateral cervical sympathectomy. This is a surgical procedure involving the excision of a portion of the sympathetic nerve chain in the neck. The fee for the surgeon is claimed with suffix A. Anaesthesia services (suffix C) are payable based on 6 base units plus time units. Surgical assistant services (suffix B) are also payable based on 6 base units plus time units.
When to Use
- Use N542 for a unilateral cervical sympathectomy procedure where only one side of the sympathetic chain is excised.
- Use this code for patients requiring surgical intervention for conditions like hyperhidrosis or complex regional pain syndrome when conservative management has failed.
Common Pitfalls
- Billing N542 bilaterally; if both sides are performed, you must use N543 (bilateral cervical sympathectomy) rather than claiming N542 twice.
- Failing to document the specific level of the sympathetic chain excised, which is necessary to distinguish N542 from other spinal or nerve procedures.
- Attempting to claim an after-hours premium (E409/E410) on an elective procedure that was not delayed by an intervening surgical emergency.
Billing Tips
- Ensure the surgical assistant (suffix B) and anaesthesia (suffix C) claims are submitted with the same procedure date and patient information to avoid automatic rejection of the associated service premiums.
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