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N504
N504 – Disc excision (one level)
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
N504 is for the anterior decompression of the thoracic spine by excising one intervertebral disc. This specific code is used when the thoracotomy portion of the surgery is performed by a separate surgeon. The service is eligible for suffix A (surgeon), B (assistant), and C (anaesthetist). For decompression of an additional level during the same operation, see add-on code E360. If the same surgeon performs both the thoracotomy and the disc excision, use N502.
When to Use
- Use N504 when performing an anterior thoracic disc excision where a separate surgeon is responsible for the thoracotomy approach.
- Use N504 in conjunction with E360 if you are decompressing additional thoracic levels during the same operative session.
Common Pitfalls
- Billing N504 when you performed the thoracotomy yourself; N502 is the mandatory code when one surgeon performs both the approach and the excision.
- Attempting to bill N504 for cervical or lumbar procedures; this code is strictly limited to the thoracic spine.
- Failure to document the involvement of a separate surgeon for the thoracotomy, which is a prerequisite for the validity of this specific code.
Billing Tips
- Always append E360 for each additional level beyond the first to ensure full compensation for multi-level thoracic decompressions.
- Ensure your operative report clearly delineates the separate surgeon's role in the thoracotomy to prevent audit rejections regarding the N504/N502 distinction.
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