E366 – Additional disc level fused
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This code is payable for each additional disc level fused with instrumentation, in conjunction with a primary spinal arthrodesis procedure. It is applicable to cervical, thoracic, and lumbar fusions. This fee is added to the primary surgical code (e.g., E365, N516, N517, N518, N559, N580, E384, E370, N528, N513, N532, N515, or N582). For posterior cervical fusions, this code is used for additional levels below and is not applicable for fusion to the occiput (E371) or fusion of the cervico-thoracic junction (E377).
When to Use
- Use E366 for each additional disc level fused with instrumentation beyond the primary level covered by codes such as E384, N528, or N532.
- Apply this code for additional levels in cervical, thoracic, or lumbar arthrodesis procedures where instrumentation is utilized.
Common Pitfalls
- Do not use E366 for posterior cervical fusion levels involving the occiput, as these are restricted; use E371 instead.
- Avoid using E366 for cervico-thoracic junction fusions, which are specifically excluded and require E377.
- Be aware that claiming E370 with E384, N513 with N528, or N515 with N532 will trigger an automatic reduction to E366 by the Ministry.
Billing Tips
- Ensure the primary surgical procedure code is correctly identified first, as E366 is strictly an add-on code that relies on the primary arthrodesis code for validity.
- When billing multiple levels, ensure the quantity of E366 reflects the total number of additional levels fused beyond the primary level.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Procedure
Spinal Surgical Procedures
Submit claims for levels fused in addition to E384 or E370 using one of E366, E371 or E377 as appropriate.
Submit claims for levels fused in addition to N528 or N513 using one of E366, E371, or E377 as appropriate.
Submit claims for levels fused in addition to N532 or N515 using one of E366, E371, or E377 as appropriate.
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