N580 – One disc level
OHIP Otolaryngology Code — SPINAL SURGICAL PROCEDURES · Schedule of Benefits
Anterior spinal arthrodesis for one lumbar disc level with instrumentation, performed without decompression. This code is specifically used when the laparotomy or retroperitoneal approach is performed by a separate surgeon. Billing and Service Components: - Additional Levels: For each additional disc level fused during the same operation, use add-on code E366. - Surgical Assistant: The fee for an assistant (N580B) is based on 7 base units plus time units. See - for calculation rules. - Anaesthesia: The fee for anaesthesia (N580C) is based on 10 base units plus time units, with potential for extra units based on patient factors (e.g., age, ASA status). See - for calculation rules. General Rules: - This service includes all common elements of insured services as defined in -. - When rendered by a Medical Trainee, payment is subject to the rules for Supervision of Postgraduate Medical Trainees (-).
When to Use
- Use N580 when performing an anterior lumbar spinal arthrodesis with instrumentation where a separate surgeon (e.g., a general or vascular surgeon) performs the laparotomy or retroperitoneal exposure.
- Use this code exclusively for procedures without decompression; if decompression is performed, you must select the appropriate alternative spinal surgery code.
Common Pitfalls
- Billing N580 when you performed the approach yourself; this code specifically requires a separate surgeon for the exposure.
- Failing to append E366 for additional levels, which results in significant under-billing for multi-level fusions.
- Attempting to bill N580 alongside decompression codes, which will trigger a rejection as N580 is strictly for arthrodesis without decompression.
Billing Tips
- Ensure the operative report clearly identifies the separate surgeon who performed the approach to satisfy audit requirements for the N580 criteria.
- Always verify that the instrumentation is documented in the operative note, as it is a mandatory component for the validity of the N580 fee.
Effective: April 1, 2025
Z. Spinal Surgical Procedures
SPINAL SURGICAL PROCEDURES
Surgical
Spinal Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Lumbar - laparotomy/retroperitoneal approach by separate surgeon
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