N522 – Re-opening of laminectomy for repair of CSF leak
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This fee code represents a surgical procedure listed within the Musculoskeletal System section of the OHIP Schedule of Benefits. As a surgical procedure, it includes fees for the performing surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C), where applicable. The fees for assistant and anaesthesia services are calculated based on basic units and time units as outlined in the General Preamble (-). The service is subject to various premiums, including those for age (), after-hours services (, , ), and trauma (). Specific details of the procedure are not available in the provided context.
When to Use
- Use N522 when performing a re-operation specifically to address a post-operative cerebrospinal fluid leak following a primary laminectomy.
- Use this code when the surgical intent is the repair of the dural defect identified after the initial spinal procedure.
Common Pitfalls
- Billing N522 in conjunction with N521 (re-opening of laminectomy for hematoma) is strictly prohibited by the Schedule of Benefits.
- Attempting to bill N522 alongside other spinal surgical procedures is generally rejected, except for the specific inclusion of E382 (duroplasty) when clinically necessary.
Billing Tips
- Always append E382 if a graft or synthetic patch is utilized during the repair, as this is the only permitted add-on for this specific procedure.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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