R248 – Total knee replacement with take down of fusion
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee code represents a surgical procedure from the Musculoskeletal System section of the OHIP Schedule of Benefits. The specific description from page is "Total knee replacement with take down of fusion". Payment is subject to the general rules for surgical procedures outlined in the General Preamble. This includes rules for the surgeon (A suffix), surgical assistant (B suffix), and anaesthetist (C suffix). See the various sections for applicable premiums and modifiers.
When to Use
- Use R248 specifically when converting a previously fused knee joint (arthrodesis) into a total knee arthroplasty.
- Select R248 instead of R441 or R482 when the surgical complexity involves the formal takedown of a bony or fibrous fusion.
Common Pitfalls
- Billing R248 in conjunction with R441 is a duplicate billing error, as R248 is a distinct procedure for a specific anatomical history.
- Failing to include E598 when a patellar replacement is performed during the same operative session results in lost revenue, as E598 is explicitly eligible for addition to R248.
- Attempting to claim a second surgical assistant without prior written authorization from a medical consultant will result in automatic rejection.
Billing Tips
- Ensure the operative report clearly documents the takedown of the fusion to justify the higher complexity of R248 compared to standard primary arthroplasty codes.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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