N516 – Anterior spinal arthrodesis with instrumentation without decompression - cervical - one disc level
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
N516 represents an anterior spinal arthrodesis with instrumentation performed at a single cervical disc level, without decompression. This surgical service includes all common elements of insured services as outlined in - of the Schedule. The fee listed is for the primary surgeon (suffix A). When a surgical assistant is required (suffix B), the fee is calculated based on 7 basic units plus time units as per -. When anaesthesia is provided (suffix C), the fee is calculated based on 10 basic units plus time units as per -. For each additional disc level fused, use add-on code E366.
When to Use
- Use N516 for a single-level anterior cervical discectomy and fusion (ACDF) with instrumentation where no neural decompression is performed.
- Use N516 as the primary procedure code when performing a single-level fusion; if multiple levels are fused, bill N516 for the first level and E366 for each subsequent level.
Common Pitfalls
- Billing N516 in conjunction with a decompression code (e.g., N517) is often flagged; ensure the clinical documentation explicitly supports the absence of decompression if N516 is used alone.
- Failing to document the specific number of levels fused can lead to under-billing; ensure E366 is appended for every level beyond the first to capture the full scope of the procedure.
Billing Tips
- Always verify if the procedure meets the criteria for E409 or E410 if performed on an urgent or emergent basis outside of standard operating hours, as these premiums apply to the base fee of N516.
- When multiple levels are fused, ensure the claim reflects N516 as the primary service and E366 as the secondary add-on to ensure the correct total fee calculation.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
Spinal Surgical Procedures
Anaesthesia basic units: 10.
Assistant basic units: 7.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.