R246 – Excision bony ridge to include interpositional materials
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of a bony ridge to include interpositional materials. This service is listed as a surgical procedure for the fibula and tibia, typically for the removal of a tumour, under the Musculoskeletal System section.
When to Use
- Use R246 specifically for the excision of a bony ridge in the tibia or fibula where an interpositional material is utilized as part of the surgical repair.
- Select this code when performing a targeted excision of a bony prominence or tumor involving the fibula or tibia that necessitates the placement of graft or spacer material.
Common Pitfalls
- Billing R246 for general bone debridement or simple exostosis removal that does not involve the placement of interpositional materials will lead to audit discrepancies.
- Failing to document the specific interpositional material used in the operative report is a common cause for claim rejection, as the code definition explicitly requires this component.
Billing Tips
- Ensure the operative report clearly details both the excision of the bony ridge and the specific nature of the interpositional material to satisfy the code's requirements.
- If performing this procedure as part of a larger trauma case, ensure the Injury Severity Score (ISS) is documented in the chart to support the addition of the E420 trauma premium.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in the medical record to establish that the service was provided, is the service submitted for payment, and was medically necessary (:).
An operative report is required for surgical procedures.
If claiming the trauma premium (E420), the patient's Injury Severity Score (ISS) must be listed in the medical record (:).
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