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N526

N526Artificial disc insertion

OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits

This service is for the insertion of an artificial spinal disc and includes the surgical approach. Per the note on page of the Schedule, no other services in the Spinal Surgical Procedures section are eligible for payment when rendered with N526, with the exception of E394 for each additional level replaced. The service is eligible for surgeon (A), assistant (B), and anaesthetist (C) suffixes. The assistant's fee is based on 11 basic units plus time units. The anaesthetist's fee is based on 17 basic units plus time units.

When to Use

  • Use N526 for the primary insertion of an artificial spinal disc when the surgeon performs both the approach and the disc insertion.
  • Use N526 in conjunction with E394 when performing a multi-level artificial disc replacement during the same operative session.

Common Pitfalls

  • Billing any additional spinal procedure codes from the Spinal Surgical Procedures section alongside N526 will trigger an automatic rejection, as N526 is all-inclusive.
  • Attempting to bill N525 (which assumes a separate surgeon for the approach) when you have performed the entire procedure yourself will lead to incorrect billing and potential audit flags.

Billing Tips

  • Ensure that only E394 is added to the claim for additional levels; all other surgical components, including the approach, are already bundled into the N526 fee.
Provider Fee$2,040.00
Surgical Assistant Fee$137.61
Anaesthetist Fee$263.33
Non-Anaesthetist Fee$263.33

Effective: April 1, 2025

Category

Z. Spinal Surgical Procedures

Subcategory

SPINAL SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Spinal Surgical Procedures

No other services in the Spinal Surgical Procedures section are eligible for payment when rendered with insertion of an artificial disc (N525, N526) except E394.

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