E373 – Repeat decompression premium
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
The repeat decompression premium (E373) is payable as a 30% add-on to the fee for the major 'N' prefix decompressive procedure. This premium is only applicable when the surgery performed is a repeat decompression. The premium applies to the following codes: - N500 - N501 - N502 - N503 - N504 - N505 - N506 - N507 - N508 - N579 - N509 - N510 - N511 - N512
When to Use
- Use E373 when performing a revision decompression at the same spinal level where a previous decompression procedure (e.g., N500-N512) was already completed.
- Apply this premium when operating on a patient with recurrent stenosis requiring re-entry into a previously operated site.
Common Pitfalls
- Billing E373 for a primary decompression procedure; it is strictly reserved for repeat surgeries at the same level.
- Failing to link E373 to the primary 'N' prefix code, which will result in an automatic rejection as it is a percentage-based add-on.
- Confusing E373 with E375; ensure you are not double-claiming premiums if the surgical criteria for both are not met.
Billing Tips
- Ensure the operative report explicitly states the previous surgical history at the specific level to justify the 'repeat' status during a potential audit.
- Always bill E373 on the same claim as the primary N-code (e.g., N500) to ensure the 30% calculation is applied correctly by the system.
Percentage Premium: 0.3%
This code applies a percentage increase to the base procedure fee
Effective: July 1, 2013
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
PercentageIncrease
Spinal Surgical Procedures, Other Premiums (including After Hours Procedure Premiums)
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