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R301
R301 – Bone - Sesamoid, one or both
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical excision of one or both sesamoid bones, a procedure performed on the foot. This is classified under Musculoskeletal System Surgical Procedures, found in the of the Schedule of Benefits.
When to Use
- Use R301 for the surgical excision of one or both sesamoid bones of the foot, regardless of whether one or both are removed during the same session.
- Use this code for chronic sesamoiditis or sesamoid fracture that has failed conservative management and requires formal excision.
Common Pitfalls
- Do not bill R301 in conjunction with other foot surgery codes if the excision is considered an integral part of a more comprehensive procedure, as this may trigger a claim rejection for unbundling.
- Avoid billing R301 for simple diagnostic procedures or minor debridement; it is specifically intended for the surgical excision of the bone structure itself.
- Ensure the procedure is not miscoded as a general excision of a bone lesion (e.g., R010 or similar), as R301 is the specific code for the sesamoid.
Billing Tips
- If the procedure is performed on both feet during the same encounter, ensure you append the appropriate bilateral modifier (e.g., 'BI') to receive the correct payment adjustment, as R301 is defined as one or both bones on a single foot.
Provider Fee$142.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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