R240 – Revision total arthroplasty shoulder
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Revision total arthroplasty of the shoulder is a surgical procedure involving the revision of a total shoulder joint replacement prosthesis. This may include the removal, replacement, or adjustment of components of a previously implanted prosthesis. The surgeon's fee (suffix A) is a set amount. The assistant's fee (suffix B) is calculated using 9 basic units plus time units. The anaesthetist's fee (suffix C) is calculated using 15 basic units plus time units. As per , a second surgical assistant is eligible for payment for R240 without special authorization.
When to Use
- Use R240 when performing a revision of a total shoulder arthroplasty, which involves the removal, replacement, or adjustment of one or more components of a previously implanted prosthesis.
- Use R240 instead of R438 (Total shoulder arthroplasty) when the primary objective is the surgical revision of an existing failed or symptomatic shoulder implant.
Common Pitfalls
- Failure to apply the E564 premium, which provides a 35% increase to the fee for the revision of a prosthesis, is a common missed revenue opportunity.
- Billing R240 for a simple closed reduction or manipulation of a shoulder prosthesis is incorrect; these procedures fall under different codes and do not qualify for the revision arthroplasty fee.
Billing Tips
- Always append the E564 premium to your R240 claim to ensure the 35% fee increase is applied for the revision of the prosthesis.
- When a second surgical assistant is required for complex revision cases, bill their services directly as they are eligible for payment without needing prior authorization.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.