R289 – Osteotomy tibia and fibula
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee code represents a surgical procedure on the musculoskeletal system. Payment includes the surgeon's fee for performing the procedure, as well as separate calculations for anaesthesia and surgical assistant services when required. The fees for assistants and anaesthetists are based on a combination of base units and time units, as detailed in the General Preamble. See for Surgical Assistant rules and for Anaesthesiologist rules.
When to Use
- Use R289 for a formal osteotomy involving both the tibia and fibula, typically for corrective realignment or malunion management.
- Select R289 when the procedure involves deliberate bone cutting of both structures, distinguishing it from simple fracture fixation codes like R287.
Common Pitfalls
- Do not bill R289 in conjunction with R287 for the same site, as the osteotomy is considered the primary procedure and includes the necessary fixation.
- Avoid billing R289 if only a single bone is osteotomized; ensure the operative report explicitly confirms both tibia and fibula were addressed to justify the fee.
Billing Tips
- Ensure the 15% age premium is applied if the patient is 65 or older, as this is a surgical procedure eligible under GP64.
- If performing bilateral osteotomies, remember that the anaesthesia and surgical assistant units are calculated based on the major procedure fee only.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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