R285 – Carpal bone excision (one)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure involving the excision of one carpal bone. This is a surgical procedure with specific base units for anaesthesia and surgical assistance. The total fee for anaesthesia and assistance is calculated based on these base units plus time units as defined in the Schedule of Benefits. As a surgical service, this fee includes all constituent and common elements as defined in the General Preamble (see -, -).
When to Use
- Use R285 for the isolated excision of a single carpal bone, such as a proximal row carpectomy or excision of a necrotic bone (e.g., Kienböck’s disease).
- Select R285 when the procedure is limited to one bone; if multiple carpal bones are excised, you must bill the appropriate code for total or partial carpectomy (e.g., R316 or R317) rather than multiple units of R285.
Common Pitfalls
- Billing R285 in conjunction with other wrist procedures that are considered 'constituent elements' under the General Preamble, such as synovectomy or capsulotomy, which are included in the surgical fee.
- Attempting to bill a second surgical assistant without prior authorization; R285 is not on the pre-approved list for second assistants, and claims will be rejected without medical consultant approval.
Billing Tips
- Ensure the operative report clearly specifies which single carpal bone was excised to justify the use of R285 over more extensive carpectomy codes like R316 or R317.
- If the procedure is performed on an emergency basis after hours, ensure you apply the appropriate E409 or E410 premium to the procedural fee, provided the criteria for non-elective status are met.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.