What is OHIP billing code R249?

R249 is "Sequestrectomy and/or saucerization", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R249 pay?

The current OHIP fee for R249 is $379.50, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R249 to OHIP?

R249 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R249 claims against the Schedule of Benefits rules before submission.

All codes

R249

R249 – Sequestrectomy and/or saucerization

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Sequestrectomy is a surgical procedure performed on the pelvis or hip, categorized under Incision and Drainage. It involves the surgical removal of a sequestrum, which is a piece of dead bone tissue that has become separated from healthy bone, often as a result of infection (osteomyelitis). The fee for this service applies to the surgeon (suffix A), with separate calculations for assistant (suffix B) and anaesthetist (suffix C) services based on basic and time units.

When to Use

Use R249 when performing the surgical excision of a sequestrum specifically from the pelvis or hip in the context of osteomyelitis.
Select R249 for saucerization procedures on the pelvis or hip where the bone is surgically shaped to facilitate drainage and healing of a chronic infection.

Common Pitfalls

Billing R249 for sequestrectomy procedures performed on anatomical sites other than the pelvis or hip will result in rejection; ensure the site matches the code definition.
Attempting to bill a second surgical assistant without prior authorization from a medical consultant will lead to automatic rejection, as R249 is not on the pre-approved list for multiple assistants.

Billing Tips

Ensure the operative report explicitly documents the removal of a sequestrum or the performance of saucerization to support the use of R249 over more generic incision and drainage codes.
When billing for assistant (suffix B) or anaesthetist (suffix C) services, ensure the correct basic units (6 for B, 7 for C) are applied alongside the appropriate time units to avoid payment discrepancies.

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Provider Fee$379.50

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

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