All codes
E374
E374 – Foramen magnum decompression < 3cm
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
foramen magnum decompression < 3cm as part of cervical decompression, to N510
When to Use
- Use E374 when performing a limited foramen magnum decompression of less than 3cm in conjunction with a primary cervical decompression procedure coded as N510.
- Apply this code specifically when the surgical approach requires extending the decompression into the foramen magnum to address cervicomedullary compression during a standard cervical laminectomy or decompression.
Common Pitfalls
- Billing E374 as a standalone procedure will result in rejection, as it is strictly an add-on code that requires the presence of N510 on the same claim.
- Attempting to bill E374 for decompressions exceeding 3cm is an audit risk; larger decompressions may require different procedural coding or clinical justification for the extent of the bone removal.
Billing Tips
- Ensure the operative report explicitly documents the measurement of the decompression to justify the 'less than 3cm' criteria required for this specific add-on code.
- Always link E374 to the primary N510 procedure on the same claim to ensure the Ministry recognizes the surgical hierarchy and prevents automatic rejection.
Provider Fee$357.00
Effective: April 1, 2025
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
Add-on
Code Classes
Diagnostic and Therapeutic Procedures
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