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N557
N557 – Syringo-subarachnoid shunt
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
Syringo-subarachnoid shunt is a neurological surgical procedure. The fee for this service is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) billing. The note in the Schedule on page specifies that N557 is not eligible for payment when rendered with any decompressive service. The E383 acute spinal cord injury premium may be added if applicable.
When to Use
- Use N557 for the surgical placement of a syringo-subarachnoid shunt to treat symptomatic syringomyelia.
- Use N557 when performing a shunt procedure for an acute spinal cord injury patient, ensuring the E383 premium is added to the claim.
Common Pitfalls
- Billing N557 concurrently with any spinal decompressive procedure will result in a claim rejection, as these are explicitly restricted by the Schedule.
- Failure to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium will lead to audit recovery.
Billing Tips
- Always verify the patient's age at the time of the procedure to apply the correct percentage increase from the age-based premium list, as these apply to surgeon, assistant, and anaesthetist fees.
Provider Fee$1,224.00
Surgical Assistant Fee$100.08
Anaesthetist Fee$185.88
Non-Anaesthetist Fee$185.88
Effective: April 1, 2025
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Spinal Surgical Procedures
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