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R239
R239 – Sequestrectomy
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Sequestrectomy is an incision and drainage procedure involving the surgical removal of a sequestrum, which is a piece of dead bone that has become separated from sound bone during necrosis. This procedure is specified for the tibia and/or fibula under Musculoskeletal System Surgical Procedures.
When to Use
- Use R239 specifically for the surgical removal of a sequestrum from the tibia or fibula when the procedure is performed as a distinct, primary surgical event.
- Use this code when debridement of necrotic bone is the primary objective, distinguishing it from general wound debridement codes like Z226 which are typically used for soft tissue management.
Common Pitfalls
- Billing R239 alongside other musculoskeletal procedures on the same site may trigger a 'multiple procedure' reduction or rejection; ensure you are not unbundling a more comprehensive procedure.
- Failing to document the specific anatomical location (tibia or fibula) can lead to audit scrutiny, as R239 is restricted to these specific bones.
Billing Tips
- If the procedure is performed on an emergency basis after hours, ensure you append the appropriate E409 or E410 premium to the R239 claim to capture the 50% or 75% increase.
- Verify that the procedure is truly a sequestrectomy; if the operative report describes only soft tissue debridement or irrigation without bone removal, R239 is inappropriate and may be recovered during an audit.
Provider Fee$329.40
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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