R259 – Osteotomy - ulna
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the osteotomy of the ulna bone, typically performed to correct a deformity or address a condition affecting the ulna in the forearm. This service is claimable by the surgeon (suffix A), assistant (suffix B), and anaesthesiologist (suffix C).
When to Use
- Use R259 for a corrective osteotomy of the ulna to address angular deformities or malunion, distinguishing it from R261 which pertains to the radius.
- Select this code for ulnar shortening osteotomies performed to address ulnar impaction syndrome, provided the procedure is limited to the ulna.
Common Pitfalls
- Billing R259 alongside a radial osteotomy (R261) without applying the multiple procedure rule, which requires the secondary procedure to be billed at 50% of the fee.
- Attempting to claim a hospital admission assessment or subsequent hospital visit on the same day as the surgery, which is disallowed as it is considered included in the surgical fee.
Billing Tips
- Ensure the operative report explicitly details the osteotomy of the ulna to support the claim, as vague descriptions of 'forearm surgery' may lead to audit recovery.
- If performing a bilateral procedure, bill the second side at 50% of the fee using the appropriate bilateral indicator to ensure correct processing.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
An appropriate operative report must be included in the patient's medical record.
The medical record must establish that the service was provided and medically necessary, as per general OHIP requirements.
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