R261 – Osteotomy - radius with or without ulna
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for an osteotomy of the radius with or without the ulna. As with all insured services, this procedure includes the common elements outlined in - of the Schedule, such as obtaining patient history, maintaining medical records, and arranging follow-up care. The fee for the surgical assistant (suffix B) is calculated based on a combination of basic units and time units as described on -. The fee for the anaesthetist (suffix C) is calculated based on a combination of basic units and time units as described on -.
When to Use
- Use R261 for corrective osteotomies of the radius, such as those performed for malunion or deformity correction, regardless of whether a concurrent ulnar osteotomy is performed.
- Use R261 for radial osteotomies required for limb lengthening or angular correction procedures.
Common Pitfalls
- Do not bill R261 in conjunction with other radial or ulnar fracture fixation codes; the osteotomy code is intended for planned reconstructive procedures, not acute fracture management.
- Avoid billing a second surgical assistant without prior authorization, as R261 is not on the pre-approved list for multiple assistants and will be rejected without a supporting letter of necessity.
- Ensure the surgical report clearly distinguishes the osteotomy from simple hardware removal or soft tissue procedures to avoid audit flags for unbundling.
Billing Tips
- If the procedure is non-elective and performed after hours, ensure the appropriate premium (E409A or E410A) is appended to the R261 claim to capture the 50% or 75% increase.
- When billing for the surgical assistant (suffix B), verify that the assistant's time units are accurately calculated based on the start and end times of the procedure to avoid discrepancies during claim adjudication.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary, as per .
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