R272 – Bone tumour
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Represents a surgical procedure within the Musculoskeletal System section of the OHIP Schedule of Benefits. The specific nature of this procedure is not detailed in the provided context.
Services for this code are claimed with a suffix:
- Suffix A (Surgeon): Includes the surgical procedure itself, pre-operative assessment leading to the decision to operate, and post-operative care.
- Suffix B (Assistant): Includes preparation of the patient, assisting the surgeon, and post-operative monitoring. The fee is calculated using basic units plus time units. See unitBasedInfo and billingInteractions for details.
- Suffix C (Anaesthetist): Includes pre-anaesthetic evaluation, administration of anaesthesia, and post-anaesthetic follow-up. The fee is calculated using basic units plus time units. See unitBasedInfo and billingInteractions for details.
For details on the constituent elements common to all insured services, see pages -.
When to Use
- Use R272A for the definitive surgical excision or resection of a confirmed bone tumour when no other more specific site-based musculoskeletal procedure code applies.
- Use R272A for open biopsy procedures of bone tumours where the primary intent is the diagnostic management of a suspected osseous neoplasm.
Common Pitfalls
- Failing to provide the required supporting letter and operative report for Independent Consideration (IC) review, which leads to automatic claim rejection.
- Incorrectly billing R272A for minor soft tissue procedures or simple aspirations that are more accurately captured by other musculoskeletal codes.
- Neglecting to document the start and end times in the operative record, which is mandatory for the calculation of time-based units for suffixes B and C.
Billing Tips
- When submitting for IC, explicitly compare the complexity, duration, and anatomical difficulty of the R272A procedure against a similar non-IC musculoskeletal code to justify the requested fee.
- Ensure that if the surgery is cancelled after the anaesthetic has commenced, you switch to E006B or E006C rather than attempting to claim the full R272 fee.
No fee information available.
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records that establish the service was provided, is the service for which the account is submitted, and was medically necessary.
For services involving time units, the start and end times must be recorded in the patient's medical record.
A supporting letter explaining the amount of the fee claimed, an appropriate operative or consultation report, and a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule.
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