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E365
E365 – Anterior spinal arthrodesis with instrumentation including cages - one disc level
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on service for anterior spinal arthrodesis with instrumentation, including cages, for one disc level, following decompression. It must be claimed with one of the specified primary procedures: * For Cervical spine: To be added to N500, N501, N572, N560 or N561. * For Thoracic/Lumbar spine: To be added to N502, N503, N504, N505, N506, N507, N508, N579, N560 or N561. For fusion of more than one level, use E366 for each additional level.
When to Use
- Use E365 when performing an anterior spinal arthrodesis with instrumentation and cage placement at a single disc level following a primary decompression procedure (e.g., N500 or N502).
- Use E365 as the base add-on code for the first level of fusion when multiple levels are addressed, provided the primary decompression code is also billed.
Common Pitfalls
- Billing E365 alongside N525 or N526 will result in an automatic rejection, as artificial disc insertion is mutually exclusive with this arthrodesis code.
- Attempting to bill E365 without an eligible primary decompression code (e.g., N500-N508, N572, N579, N560, N561) will lead to claim denial.
- Failing to use E366 for subsequent levels beyond the first level will result in under-billing for multi-level procedures.
Billing Tips
- Always ensure the primary decompression code is listed first on the claim to establish the surgical context required for the E365 add-on.
- If performing a multi-level fusion, claim E365 for the first level and E366 for each additional level to correctly capture the total surgical effort.
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