R263 – Hip osteotomy
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for osteotomy of the hip. This involves cutting and reshaping the hip bone to correct deformities. The fee for the surgeon is for the procedure itself (<suffix>A</suffix>). Additional fees are payable for assistant and anaesthetist services. - The assistant service (<suffix>B</suffix>) is calculated using 6 base units plus time units as per rules on -. - The anaesthetist service (<suffix>C</suffix>) is calculated using 7 base units plus time units as per rules on -.
When to Use
- Use R263 for formal osteotomy procedures of the hip intended to correct structural deformities or malalignment.
- Distinguish R263 from R328 (Hip arthroplasty) by ensuring the procedure involves bone resection and realignment rather than joint replacement.
Common Pitfalls
- Billing a hospital admission assessment on the same day as R263 is a common rejection unless it qualifies as the 'major pre-operative visit' for surgical scheduling.
- Attempting to bill a second surgical assistant without prior authorization from a medical consultant will result in an automatic claim rejection.
Billing Tips
- Ensure the surgical assistant (suffix B) and anaesthetist (suffix C) claims are submitted with the correct base units (6 and 7 respectively) plus time units to avoid payment discrepancies.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
An operative report must be included in the patient's medical record.
All insured services must be documented in the patient's medical record to establish that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary.
The fee for a second assistant is only eligible for payment upon authorization by a medical consultant as per .
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