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N528
N528 – C1/C2 screw fixation (transarticular, pedicle, lateral mass)
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This service is for a posterior spinal arthrodesis involving / screw fixation, which may be transarticular, pedicle, or lateral mass. It is performed as part of a cervical spine procedure with instrumentation. This code is specifically used when the arthrodesis and instrumentation are performed by a surgeon who is separate from the surgeon performing the primary decompression or osteotomy.
When to Use
- Use N528 when you are the separate surgeon performing C1/C2 screw fixation (transarticular, pedicle, or lateral mass) while another surgeon performs the primary decompression or osteotomy.
- Use N528 as the base code when performing posterior spinal arthrodesis with instrumentation specifically at the C1/C2 level as a distinct surgical component.
Common Pitfalls
- Billing N513 alongside N528 will result in an automatic reduction of the N513 fee to the E366 rate, as N513 is considered an additional level when N528 is the primary procedure.
- Attempting to claim E366, E371, or E377 without N528 or N513 as the base code will lead to claim rejection, as these are strictly add-on codes.
- Failing to document the 'separate surgeon' status in the operative report can trigger audit flags, as this is a mandatory requirement for the validity of the N528 billing category.
Billing Tips
- Always ensure the primary surgeon's billing does not overlap with your instrumentation codes to avoid duplicate payment denials for the same surgical levels.
- Use E371 for occiput fusion, E377 for cervico-thoracic junction, and E366 for all other additional disc levels to ensure correct fee application.
Provider Fee$1,020.00
Effective: April 1, 2025
Category
Z. Spinal Surgical Procedures
Subcategory
SPINAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Spinal Surgical Procedures, Musculoskeletal System Surgical Procedures
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