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N509
N509 – One level - unilateral
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
N509 is a surgical procedure listed under the Musculoskeletal System section. The amount payable varies based on the physician's role: surgeon (suffix A), assistant (suffix B), or anaesthetist (suffix C). Assistant and anaesthetist fees are calculated based on basic and time units as outlined in the General Preamble. Additional premiums may apply for services rendered after hours, for trauma cases, or based on the patient's age.
When to Use
- Use N509 for a single-level unilateral laminectomy, foraminotomy, or facetectomy where the procedure is limited to one side of the spine.
- Use N509 as the base procedure code when performing a single-level unilateral decompression, and append E368 if a concurrent disc excision is performed at that same level.
Common Pitfalls
- Billing N509 alongside E361 for the same level; E361 is strictly for additional levels beyond the primary level covered by N509.
- Failing to document the specific level and laterality, which is required to support the use of N509 over bilateral codes like N510.
- Attempting to claim N509 with E420 (Trauma Premium) and an after-hours premium (E409/E410) simultaneously, which is prohibited by the General Preamble.
Billing Tips
- Always append E368 to N509 if a disc excision is performed during the same operative session, as N509 alone covers the decompression but not the excision.
- For multi-level procedures, bill N509 as the primary code and use E361 for each additional level decompressed to ensure correct cumulative payment.
Provider Fee$1,004.70
Surgical Assistant Fee$112.59
Anaesthetist Fee$185.88
Non-Anaesthetist Fee$185.88
Effective: April 1, 2025
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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