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E369

E369Posterior spinal arthrodesis - one disc level

OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits

Posterior spinal arthrodesis for a single disc level in the cervical, thoracic, or lumbar spine, performed without instrumentation. This service is intended as an add-on procedure following a primary decompression or osteotomy, specifically to be billed with N509, N510, N520, N511, or N512. For fusion of additional levels, E364 should be used. As a surgical procedure, this service includes all common elements as defined in the Schedule of Benefits (see -).

When to Use

  • Use E369 as an add-on code when performing a posterior spinal arthrodesis without instrumentation immediately following a primary decompression procedure such as N509, N510, N511, N512, or N520.
  • Use E369 for the first disc level fused in a non-instrumented posterior fusion; subsequent levels must be billed using E364.

Common Pitfalls

  • Billing E369 as a standalone procedure will result in an automatic rejection; it must be linked to one of the five specified primary decompression codes.
  • Attempting to bill E369 for procedures involving instrumentation or artificial disc insertion is a common audit trigger, as it is strictly limited to non-instrumented arthrodesis.
  • Failing to use E364 for additional levels fused beyond the first level will result in under-billing for multi-level procedures.

Billing Tips

  • Ensure the primary decompression code (N509, N510, N511, N512, or N520) is listed first on the claim to establish the surgical context required for the E369 add-on.
Provider Fee$255.00

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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