E377 – Cervico-thoracic junction fusion
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on surgical procedure for the fusion of the cervico-thoracic junction, performed in conjunction with a primary posterior spinal arthrodesis procedure that involves instrumentation. It is claimed in addition to one of the following primary procedures, depending on the context: Following Decompression or Osteotomy (instrumentation by same surgeon): - Add to N509, N510, E370, N572, N574, N560 or N561. Following Decompression or Osteotomy (instrumentation by separate surgeon): - Add to N513, N572, N574, N560 or N561. As Sole Procedure (with instrumentation): - Add to N515 or N572. When multiple additional levels are fused, E377 is used specifically for the cervico-thoracic junction, while E366 is used for other levels and E371 for fusion to the occiput.
When to Use
- Use E377 specifically when performing a fusion at the cervico-thoracic junction (typically C7-T1) as an add-on to a primary posterior spinal arthrodesis procedure involving instrumentation.
- Use E377 when the cervico-thoracic junction is included in a multi-level fusion construct alongside other levels billed under E366.
- Use E377 when performing a sole-level fusion at the cervico-thoracic junction in conjunction with instrumentation as an add-on to N515 or N572.
Common Pitfalls
- Billing E377 for fusion levels that are not at the cervico-thoracic junction; use E366 for standard spinal levels and E371 for occipital-cervical fusion.
- Attempting to bill E377 without a valid primary procedure code (such as N509, N510, or N513) present on the same claim, which will result in an automatic rejection.
- Failing to confirm that instrumentation is included in the primary procedure, as E377 is specifically intended for instrumented fusion constructs.
Billing Tips
- Always ensure the primary procedure code is listed first on the claim to establish the surgical context required for the E377 add-on.
- When performing extensive multi-level fusions, clearly delineate between E377 (cervico-thoracic), E366 (other levels), and E371 (occiput) to ensure accurate payment for each distinct anatomical zone.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
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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