N518 – Anterior spinal arthrodesis with instrumentation without decompression - Thoracic - thoracotomy by separate surgeon - One disc level
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This procedure involves the fusion of one thoracic vertebra to another from an anterior approach, including the placement of instrumentation. N518 is specifically claimed by the surgeon performing the arthrodesis when the thoracotomy (the surgical approach through the chest) is performed by a different surgeon. The fee for the thoracotomy itself is claimed separately by the other surgeon. For each additional disc level fused during the same operative session, claim E366.
When to Use
- Use N518 when you are the surgeon performing the anterior spinal arthrodesis and instrumentation, but a separate surgeon (e.g., a thoracic surgeon) is performing the thoracotomy approach.
- Use N518 for the first thoracic disc level fused; for any additional levels fused during the same session, use E366 as an add-on code.
Common Pitfalls
- Claiming N518 when you perform both the thoracotomy and the arthrodesis; in this case, you must use N517 instead.
- Attempting to bill N518 for a procedure that includes decompression; N518 is strictly for arthrodesis without decompression.
Billing Tips
- Ensure the thoracotomy is claimed by the separate surgeon on their own claim to avoid rejection of your N518 submission due to duplicate service or provider conflict.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
Spinal Surgical Procedures
Thoracic - thoracotomy by separate surgeon
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