R299 – Bone - Phalanx
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical excision of a phalanx bone, located in the foot or ankle. This service is a surgical procedure and includes all common elements (-14) and specific elements of a surgical service. The fee is payable to the surgeon (suffix A). The service is eligible for assistant (suffix B) and anaesthetist (suffix C) services, which are calculated using a unit-based system. Both assistant and anaesthetist services are assigned 6 base units for this procedure (). Time units are added based on the duration of the service as described in the Schedule of Benefits (, ).
When to Use
- Use R299 for the surgical excision of a single phalanx bone in the foot or ankle when performed as a primary procedure.
- Use R299 in conjunction with E587 when excising multiple phalanx bones during the same operative session.
Common Pitfalls
- Billing R299 as a bilateral procedure without applying the appropriate multiple procedure rules, which often leads to automatic payment reductions.
- Attempting to bill a second assistant for R299 without prior authorization, as it is not on the pre-approved list for multiple assistants.
- Failing to document the specific phalanx bone excised, which is required to justify the procedure code during an audit.
Billing Tips
- Ensure the procedure start time is accurately recorded to correctly calculate time units for the anaesthetist and assistant, as these are added to the 6 base units.
- Always apply the appropriate age-based premium (e.g., under 1 year or 5-16 years) to the surgical, assistant, and anaesthesia fees to maximize the claim value.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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