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N540
N540 – Posterior scoliosis correction - up to six levels
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
This code represents a posterior scoliosis correction procedure for up to six vertebral levels. The service is comprehensive, including the surgical approach, any necessary disc excision, and the placement of instrumentation. The fee for the surgeon (suffix A) is a flat rate. The fee for a surgical assistant (suffix B) is calculated based on 11 base units plus time units as per the Schedule of Benefits rules on - and -. The fee for an anaesthesiologist (suffix C) is calculated based on 20 base units plus time units as per the Schedule of Benefits rules on - and -.
When to Use
- Use N540 for posterior scoliosis correction involving up to six vertebral levels, inclusive of the surgical approach, disc excision, and instrumentation.
- Use N540 in conjunction with E389 when the correction involves more than six levels, with E389 claimed for each additional level beyond the initial six.
Common Pitfalls
- Do not attempt to bill N540 for spinopelvic fixation; the Schedule of Benefits explicitly states that L5-S1 fusion does not qualify as such.
- Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium, even if the clinical scenario otherwise qualifies.
Billing Tips
- N540 is pre-approved for a second surgical assistant without requiring prior authorization or a letter of justification from the surgeon.
- Ensure all applicable age-based premiums (e.g., AGE_PREMIUM_UNDER_16_YEARS) are applied to both the surgeon (suffix A) and the surgical assistant (suffix B) to maximize the claim value.
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