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E392

E392Kyphoplasty combined with any other procedure, first level

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

`E392` is an add-on fee payable for performing a kyphoplasty (balloon tamp and injection of bone cement) at the first spinal level when it is combined with another primary surgical procedure. For kyphoplasty at additional levels, see E393. For kyphoplasty performed as a sole procedure, see N583.

When to Use

  • Use E392 when performing a kyphoplasty at the first level during a multi-level spinal surgery or when combined with a separate primary spinal procedure.
  • Use E392 as the base code for the first level when you are also billing E393 for subsequent levels in the same operative session.

Common Pitfalls

  • Billing E392 alongside N583 is a common error; N583 is strictly for kyphoplasty as a sole procedure and is mutually exclusive with E392.
  • Attempting to bill E392 with vertebroplasty codes (N570 or E388) for the same spinal level will result in a rejection as these are restricted combinations.
  • Submitting E392 without an associated primary surgical procedure code will trigger an audit or rejection, as it is defined as an add-on fee.

Billing Tips

  • Always link E392 to the primary surgical procedure performed in the same session to justify the 'combined' status of the claim.
  • Ensure that any additional levels treated are billed specifically as E393 to correctly capture the incremental work beyond the first level.
Provider Fee$510.00

Effective: April 1, 2025

Category

Z. Spinal Surgical Procedures

Subcategory

SPINAL SURGICAL PROCEDURES

Service Type

Procedure

Code Classes

Spinal Surgical Procedures

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