N572 – Open reduction, any single level, spine fracture/dislocation, anterior/posterior
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
N572 is for the open reduction of a single-level spine fracture or dislocation, using either an anterior or posterior approach. As per the Schedule of Benefits notes, this procedure includes any necessary decompressive services at the level of the fracture, which are not separately billable. However, fusion procedures performed during the same operation are eligible for additional payment. Several add-on codes can be billed with N572 for specific circumstances, including E395 for an additional level, E383 for acute spinal cord injury, E362 for a combined thoracotomy/laparotomy approach, and E378 or E379 for stereotactic guidance.
When to Use
- Use N572 for the primary open reduction of a single-level spine fracture or dislocation, regardless of whether the surgical approach is anterior or posterior.
- Use N572 when performing an open reduction that includes inherent decompressive services at the fracture level, as these are bundled into the base fee.
Common Pitfalls
- Do not bill separate decompressive service codes for the level of the fracture, as these are strictly included in N572 and will be rejected.
- 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 patient meets clinical criteria.
Billing Tips
- Always bill E395 for each additional level of open reduction performed beyond the first level to ensure appropriate compensation for multi-level procedures.
- If performing a fusion during the same operative session, ensure it is billed as a separate eligible procedure alongside N572 to maximize the claim value.
Effective: April 1, 2026
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
Spinal Surgical Procedures
Decompressive services at the level of the fracture are not eligible for payment when rendered with N572 as they are included in the open reduction.
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