E479 – Arthroscopy of midcarpal and/or distal radio-ulnar joint, through separate portals
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Payable in addition to R682 (Wrist arthroscopy setup), E479 is for the arthroscopy of the midcarpal and/or distal radio-ulnar joint when performed through separate portals. As per the note on page , this add-on is not payable if the service it describes is considered a standard component of another arthroscopic wrist procedure performed during the same session.
When to Use
- Use E479 when performing a diagnostic or therapeutic arthroscopy of the midcarpal joint that requires the establishment of separate portals from those used for the radiocarpal joint.
- Use E479 for arthroscopic assessment or treatment of the distal radio-ulnar joint (DRUJ) when the procedure necessitates distinct portal placement beyond the primary wrist arthroscopy setup (R682).
Common Pitfalls
- Billing E479 in conjunction with other wrist arthroscopy codes where the midcarpal or DRUJ assessment is considered an inherent, standard component of the primary procedure.
- Attempting to bill E479 without the mandatory base code R682, which is required for all wrist arthroscopy add-ons.
- Failing to document the specific, separate portal placement, which is a prerequisite for justifying this add-on code during an audit.
Billing Tips
- Ensure your operative report explicitly describes the creation of separate portals for the midcarpal or DRUJ space to satisfy the specific requirements of the code definition.
- Verify that the procedure performed is not already bundled into the primary surgical code, as E479 is strictly for additional, distinct arthroscopic work.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Procedure
Musculoskeletal System Surgical Procedures
A wrist procedure listed in the Hand and Wrist section of the Schedule performed arthroscopically is eligible for payment in addition to R682 if that procedure is not described as a component of R682 or described by an E-add-on code to R682.
Arthroscopic E-add-on codes listed below are not eligible for payment in addition to R682 when the service described by the E-code is a generally accepted component of a procedure described in Note #1.
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