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R313

R313Complex reconstruction or revision of previous club foot repair

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Complex reconstruction or revision of previous club foot repair (not to include simple tendon releases).

When to Use

  • Use R313 for extensive soft tissue and bony reconstruction in patients with recurrent or resistant clubfoot deformity where simple tendon releases are insufficient.
  • Select R313 for secondary procedures involving complex revision of prior surgical repairs that require significant dissection, capsulotomies, or osteotomies.

Common Pitfalls

  • Billing R313 for simple tendon releases or minor soft tissue procedures, which are excluded by the code description and subject to audit recovery.
  • Attempting to bill R313 in conjunction with other musculoskeletal procedures without clear documentation of distinct, separate surgical sites or independent procedures.

Billing Tips

  • Ensure the operative report explicitly details the complexity of the reconstruction, such as specific osteotomies or extensive capsular releases, to justify the 'complex' designation over simpler musculoskeletal codes.
  • Always verify if the patient qualifies for age-based surgical premiums, as these significantly increase the total reimbursement for R313 given the pediatric nature of clubfoot pathology.
Provider Fee$468.65
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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