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R253
R253 – Tumour - extensive with repair
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for the extensive excision of a tumour from the tibia or fibula, which includes repair of the affected area. This is a surgical procedure and requires the use of a suffix to denote the role of the physician: R253A for the surgeon, R253B for the assistant, and R253C for the anaesthetist. Payment for assistant and anaesthetist services is based on basic units and time-based units.
When to Use
- Use R253A for extensive surgical excision of a tumour involving the tibia or fibula that necessitates a formal repair or reconstruction of the site.
- Select this code when the procedure involves significant soft tissue or bone work beyond a simple local excision, distinguishing it from minor lesion removals.
Common Pitfalls
- Submitting R253 for a second assistant without a formal letter of justification will result in automatic rejection, as it is not on the pre-approved list for second assistants.
- Failing to document the specific Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium will lead to audit recovery.
Billing Tips
- Ensure the surgical start time is clearly documented to support the application of after-hours premiums like E409 or E410, as these are based on the procedure commencement time.
Provider Fee$648.20
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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