N503 – Vertebrectomy (removal of vertebral body and excision of adjacent discs)
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
Anterior thoracic vertebrectomy, listed under 'Thoracic - includes thoracotomy', involves the surgical removal of a vertebral body and the excision of adjacent intervertebral discs via an anterior approach. The service fee includes the thoracotomy. Add-on code E360 is billable for each additional level decompressed. Add-on code E362 is billable for a combined thoracotomy/laparotomy approach. This procedure has 12 basic units for an assistant and 17 basic units for an anaesthesiologist.
When to Use
- Use N503 for the definitive anterior resection of a thoracic vertebral body, which inherently includes the required thoracotomy approach.
- Select N503 when performing a multi-level anterior thoracic vertebrectomy, ensuring that E360 is appended for each additional level beyond the first.
Common Pitfalls
- Do not bill N503 in conjunction with N569, as the schedule explicitly excludes the use of E360 when anterior cervical decompression is performed via an intra-oral approach.
- Avoid billing a separate thoracotomy code, as the thoracotomy is considered an inclusive component of the N503 procedure fee.
Billing Tips
- Always append E362 if the surgical approach requires both a thoracotomy and a laparotomy, provided the same surgeon performs both components of the approach.
- Ensure the Injury Severity Score (ISS) is clearly documented in the patient chart if claiming the E420 trauma premium, as this is a mandatory audit requirement.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
Spinal Surgical Procedures
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