R238 – Saucerization and bone grafting
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the saucerization and bone grafting of the tibia or fibula. Saucerization is the excavation of tissue to form a shallow depression, typically to treat conditions like osteomyelitis. This is followed by the application of bone graft material to facilitate healing and bone regeneration. The service includes all common elements (-) and specific elements of a surgical procedure, such as pre-operative preparation, the procedure itself, and immediate post-operative care.
When to Use
- Use R238 when performing surgical saucerization of the tibia or fibula specifically for the treatment of chronic osteomyelitis.
- Use R238 when the procedure involves the combined clinical necessity of excavating infected bone and subsequent bone grafting to promote regeneration.
Common Pitfalls
- Billing R238 with a second surgical assistant without prior authorization, as it is not on the pre-approved list and will trigger an automatic rejection.
- Failing to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium, which is a common audit trigger for musculoskeletal procedures.
Billing Tips
- Always append R238B when claiming for a surgical assistant to ensure the 6 basic units are added to your time-based units for the procedure.
- Verify if the patient is under 16 years of age to apply the appropriate age-based percentage premium, as this is a mandatory adjustment for R238.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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