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R236
R236 – Carpal replacement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Carpal replacement is a surgical arthroplasty procedure of the hand and wrist. This service is eligible for payment to the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C). The assistant's service is valued at 6 base units plus time units (, ). The anaesthetist's service is valued at 7 base units plus time units (, ).
When to Use
- Use R236 for total or partial carpal arthroplasty when replacing damaged carpal bones due to advanced arthritis or post-traumatic changes.
- Select R236 over R285 or R316 when the procedure specifically involves the replacement of carpal components rather than simple excision or fusion.
Common Pitfalls
- Billing R236 alongside R285 or R316 will trigger an automatic rejection as these codes are mutually exclusive.
- Failing to document the specific revision nature of the surgery when claiming the E564 35% add-on will lead to audit recovery.
Billing Tips
- Always append the appropriate suffix (A for surgeon, B for assistant, C for anaesthetist) to ensure the base units are calculated correctly by the system.
- If performing bilateral or multiple procedures under the same anaesthetic, ensure only the major procedure's base units are claimed for the assistant and anaesthetist to avoid overpayment flags.
Provider Fee$322.05
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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