E490 – Osteochondroplasty
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Osteochondroplasty (extensive bone and arthrofibrotic tissue removal requiring a minimum of 2 hours to resect), to R686 - add.
When to Use
- Use E490 for extensive arthroscopic or open resection of bone and arthrofibrotic tissue that specifically requires a minimum of 2 hours of operative time.
- Choose E490 when the complexity of the resection exceeds the scope of standard arthroscopic debridement (R686) due to the significant time requirement for extensive tissue removal.
Common Pitfalls
- Billing E490 without explicit documentation of the start and end times of the procedure in the operative report, which is a mandatory requirement for this time-based code.
- Attempting to bill E490 alongside E482 on the same day, which will result in an automatic rejection as they are mutually exclusive.
- Billing E490 for procedures lasting less than 2 hours; cases failing to meet this duration threshold are considered included in the fee for R686.
Billing Tips
- Ensure the operative report clearly details the extent of the bone and arthrofibrotic tissue removal to justify the 2-hour duration requirement in the event of a post-payment audit.
- Always verify that the total operative time is explicitly stated in the chart, as the Ministry strictly enforces the documentation requirements outlined in GP7 for time-dependent surgical codes.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Procedure
Musculoskeletal System Surgical Procedures
To be eligible for payment, the osteochondroplasty must require a minimum of 2 hours to resect.
The time when the insured service started and ended must be recorded in the patient's permanent medical record. If the patient's permanent medical record or chart does not include this required information, the service is not eligible for payment, as per .
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