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E363
E363 – Anterior spinal arthrodesis - cervical - without instrumentation - one disc level
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use E363 as an add-on code when performing a cervical arthrodesis at a single disc level without instrumentation following a primary decompression procedure (N500 or N501).
- Select E363 specifically for cases where the arthrodesis is achieved via graft or fusion technique that does not involve the placement of plates, screws, or other internal fixation hardware.
Common Pitfalls
- Claiming E363 in isolation without an associated primary decompression procedure (N500 or N501) will lead to automatic rejection.
- Attempting to claim E363 alongside artificial disc replacement codes (N525 or N526) is strictly prohibited and will result in claim denial.
- Billing E363 for multi-level procedures is incorrect; E364 must be used for additional levels beyond the first.
Billing Tips
- Ensure the primary decompression code (N500 or N501) is submitted on the same claim to validate the E363 add-on status.
- If the procedure is performed on an urgent or emergent basis after hours, append the appropriate premium (E409 or E410) to the procedural fee to maximize reimbursement.
Provider Fee$357.00
Effective: April 1, 2025
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Spinal Surgical Procedures
All insured services must be documented in appropriate records. The record must establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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