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N527

N527Percutaneous cordotomy or tractotomy

OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits

Percutaneous cordotomy or tractotomy is a surgical procedure listed under Spinal Surgical Procedures. This service is eligible for payment for the operating surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C), with specific base units assigned for assistant and anaesthesia services.

When to Use

  • Use N527 for percutaneous radiofrequency cordotomy in patients with intractable cancer-related pain where open surgery is contraindicated.
  • Use N527 for percutaneous tractotomy procedures performed for the management of trigeminal neuralgia or other refractory neuropathic pain syndromes.

Common Pitfalls

  • Billing N527 in conjunction with other spinal decompression or fusion codes (e.g., N050 series) without clear documentation of separate, distinct procedural sites and clinical indications, which risks audit scrutiny for unbundling.
  • Failure to append the correct suffix (A for surgeon, B for assistant, C for anaesthesiologist) will result in automatic rejection of the claim.

Billing Tips

  • Ensure the operative report explicitly details the percutaneous nature of the procedure to distinguish it from open cordotomy, as the latter may be billed under different, higher-valued surgical codes.
  • When billing for the anaesthesiologist (suffix C), ensure all applicable ASA physical status modifiers (e.g., E022C, E017C) are included to maximize the total unit calculation for this complex procedure.
Provider Fee$469.20
Surgical Assistant Fee$75.06
Anaesthetist Fee$123.92
Non-Anaesthetist Fee$123.92

Effective: April 1, 2025

Category

Z. Spinal Surgical Procedures

Subcategory

SPINAL SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Spinal Surgical Procedures

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