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R200
R200 – Allograft - cadaver - per long bone
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee code applies to the surgical procedure of implanting an allograft from a cadaver source. The service is specific to a long bone graft and is payable for each long bone used. This code is found in the Musculoskeletal System section under Bone/Fascial/Dermis Grafts.
When to Use
- Use R200 when performing the surgical implantation of a cadaveric allograft specifically for a long bone reconstruction or structural repair.
- Use this code for each distinct long bone site where a cadaveric allograft is implanted during the same operative session.
Common Pitfalls
- Do not bill R200 for autografts (bone harvested from the patient); autograft procedures are typically included in the primary surgical fee.
- Avoid billing R200 for non-long bone sites, as the code is strictly defined for long bone applications; use appropriate site-specific codes for other graft types.
- Failure to document the specific long bone site(s) can lead to audit rejections if the claim is flagged for multiple units of R200.
Billing Tips
- If multiple long bones receive allografts, bill R200 with the appropriate number of units and ensure the operative report clearly identifies each distinct site.
- Always verify if the primary surgical procedure allows for the addition of R200, as some complex reconstructions may have inclusive graft fees.
Provider Fee$144.80
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
Other donor allografts are payable at 85% of the listed excision fee.
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