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E396
E396 – Each additional site to N556
OHIP Surgical Assists Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on code for each additional site of a percutaneous vertebral facet medial branch or sacral lateral branch neurotomy. It must be claimed in addition to N556A for the first site.
When to Use
- Use for each additional vertebral facet medial branch neurotomy site beyond the first site covered by N556A.
- Use for each additional sacral lateral branch neurotomy site performed during the same operative session as the primary N556A procedure.
Common Pitfalls
- Claiming E396 as a standalone code without an associated N556A will result in an automatic rejection.
- Attempting to bill E396 for the first site, which must be billed under N556A, will lead to claim adjustment or rejection.
- Failing to clearly document the specific number of additional levels treated, which can lead to audit scrutiny if the quantity of E396 units does not match the operative report.
Billing Tips
- Ensure the number of units for E396 corresponds exactly to the number of additional sites treated beyond the primary site defined in N556A.
- Verify that the operative report explicitly lists each treated level to support the total units of E396 claimed.
Provider Fee$71.40
Effective: April 1, 2025
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Spinal Surgical Procedures, Diagnostic and Therapeutic Procedures
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