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R290
R290 – Olecranon excision
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of the olecranon, a surgical procedure on the elbow bone.
When to Use
- Use R290 for the formal surgical excision of the olecranon process, typically indicated for non-union fractures or severe post-traumatic arthritis where simple fixation is not viable.
- Select R290 when performing a partial or total olecranon resection as a distinct procedure, distinguishing it from simple debridement or hardware removal (R990/R993).
Common Pitfalls
- Do not bill R290 in conjunction with hardware removal codes like R993; if the excision is performed to facilitate hardware removal, the primary procedure (R290) is typically the only billable service.
- Avoid billing R290 for simple bursectomy or superficial soft tissue excision; ensure the operative report explicitly describes the resection of the bone itself to justify the code.
- Failure to document the specific referral source (Physician or Nurse Practitioner) can lead to audit rejections, as R290 requires a valid referral under GP16:30.
Billing Tips
- If the procedure is performed as part of a larger reconstructive surgery, ensure you are not unbundling; if multiple distinct procedures are performed, use the appropriate multiple procedure rules (usually 100% for the first and 85% for the second).
- Always verify if the procedure qualifies for the E409 or E410 after-hours premiums by confirming the start time and the non-elective status in your operative notes.
Provider Fee$208.85
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Neurological Surgical Procedures
Referral RequiredFrom: Physician, NursePractitioner, DentalSurgeon
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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