R298 – Simple excision of clavicle
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R298 represents a musculoskeletal surgical procedure. The fee listed is for the surgeon's professional component (suffix A). Additional fees for anaesthesia (suffix C) and surgical assistance (suffix B) are calculated based on basic and time units as described in the General Preamble (-). This code is eligible for age-based premiums (), trauma premiums (), and after-hours premiums (, , ). A second surgical assistant requires authorization by a medical consultant ().
When to Use
- Use R298 for the simple excision of the clavicle, such as in the treatment of symptomatic non-union or post-traumatic osteolysis.
- Select R298 when performing a distal clavicle excision, provided the procedure does not involve more complex reconstructive elements that would necessitate a different code.
Common Pitfalls
- Billing R298 alongside R416 without applying the 85% reduction rule for the secondary procedure, which will trigger an automatic adjustment or rejection.
- Attempting to bill a second surgical assistant without prior authorization from a medical consultant, as R298 does not qualify for automatic second assistant payment.
Billing Tips
- Ensure the claim reflects the 100% fee for R298 and the 85% fee for R416 when both are performed during the same operative session to avoid billing errors.
- Always document the specific start time of the procedure to accurately support the application of after-hours premiums E409 or E410.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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