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E386
E386 – Extradural decompression - spinal cord or cauda equina - tumour or infection
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This is a premium code that adds 42% to the fee of the major decompressive procedure for extradural decompression of the spinal cord or cauda equina due to a tumour or infection. Note: E386 only applies to the major decompressive procedure.
When to Use
- Apply E386 when performing a laminectomy (e.g., N553 or N554) specifically for the decompression of the spinal cord or cauda equina caused by an extradural tumour.
- Use this premium when the primary surgical indication is an extradural spinal infection, such as an epidural abscess requiring decompression, in conjunction with the base procedure.
Common Pitfalls
- Billing E386 on secondary or incidental procedures; it is strictly restricted to the major decompressive component of the surgery.
- Claiming E386 for degenerative spinal conditions like stenosis or disc herniation, as the code is explicitly limited to tumour or infection etiologies.
Billing Tips
- Ensure the operative report clearly documents the pathology as either a tumour or infection to justify the 42% premium over standard decompression codes like N549 or N550.
Percentage Premium: 0.42%
This code applies a percentage increase to the base procedure fee
Provider Fee$0.01
Effective: July 1, 2013
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
PercentageIncrease
Code Classes
Other Premiums (including After Hours Procedure Premiums), Spinal Surgical Procedures
E386 only applies to the major decompressive procedure.
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