R244 – Revision total arthroplasty knee
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R244 represents the surgical service for open reduction of a pelvic fracture with internal fixation. The service is eligible for surgeon (A), anaesthetist (C), and surgical assistant (B) fees. Notably, this procedure is pre-approved for payment for a second surgical assistant without special authorization. The anaesthetist and assistant fees are calculated based on basic and time units as outlined in the Schedule of Benefits. A variety of premiums may be applicable, including those for patient age, after-hours services, and for trauma patients with a high Injury Severity Score (ISS).
When to Use
- Use R244 specifically for the revision of a total knee arthroplasty when the procedure involves complex revision components.
- Select R244 when the surgical scope exceeds the criteria for R441, which is reserved for simpler revisions or conversions from unicondylar to total knee arthroplasty.
Common Pitfalls
- Billing R244 for a unicondylar to total knee conversion, which must be billed as R441 per the Schedule of Benefits submission instructions.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium, leading to automatic rejection.
- Omitting the E598 add-on code when a patellar replacement or patelloplasty is performed concurrently with the revision.
Billing Tips
- Ensure the second surgical assistant is billed alongside R244, as this code is pre-approved for two assistants without requiring prior medical consultant authorization.
- Verify that the anaesthesiologist includes the appropriate ASA physical status modifiers and, if applicable, the E018C premium for patients aged 80 or older to maximize the total case value.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For the E420 trauma premium to be payable, the medical record must list the Injury Severity Score (ISS).
E025C is only eligible for payment for an unanticipated transfusion of blood during a surgical procedure where: 1. greater than 70 ml/kg of red blood cells are transfused for a patient with a weight up to 50 kg; or 2. 10 or more units of red blood cells are transfused for a patient with a weight exceeding 50 kg.
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