R283 – Phalanx/metacarpal excision
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the excision of a phalanx or metacarpal bone, listed in the Hand and Wrist subsection of the Musculoskeletal System Surgical Procedures. The service is eligible for payment to the performing surgeon (suffix A), surgical assistant (suffix B), and anaesthetist (suffix C). Fees for the assistant and anaesthetist are calculated based on a combination of base units and time units. - Surgeon Fee: A flat fee as listed in the Schedule. - Assistant Fee: Based on 6 base units plus time units. - Anaesthetist Fee: Based on 7 base units plus time units.
When to Use
- Use R283 for the formal excision of a phalanx or metacarpal bone, such as in cases of chronic osteomyelitis or benign bone tumor resection.
- Select R283 when performing a partial or complete bone excision that is distinct from a simple fracture fixation or debridement, which would be billed under different musculoskeletal codes.
Common Pitfalls
- Billing R283 alongside R285 (Phalangeal fracture) or R316 (Metacarpal fracture) for the same site is a common audit trigger; ensure the excision is a distinct procedure and not part of a standard fracture reduction.
- Failure to document the specific bone excised can lead to rejections if the claim is flagged for manual review against the operative report.
Billing Tips
- If the procedure is performed on multiple bones, ensure you are not incorrectly bundling; check the Schedule of Benefits for specific rules regarding bilateral or multi-site procedures to avoid under-billing or over-billing.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
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