R315 – Head and neck, femur
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of the head and neck of the femur. This service is a surgical procedure and includes all common and specific elements as defined in the Schedule of Benefits. As per and , common elements include but are not limited to making appointments, travel, history taking, maintaining records, and providing prescriptions.
When to Use
- Use R315 for the surgical excision of the femoral head and neck, typically performed as part of a Girdlestone procedure for chronic infection or failed arthroplasty.
- Select R315 when the procedure is limited to the excision of the head and neck, distinguishing it from total hip arthroplasty codes which include prosthetic implantation.
Common Pitfalls
- Billing R315 alongside a total hip arthroplasty code is considered unbundling; ensure the procedure is distinct and not a component of a larger reconstruction.
- Failure to document the Injury Severity Score (ISS) in the medical record when claiming the trauma premium (E420) will result in an automatic rejection of the premium.
- Assuming automatic eligibility for a second surgical assistant; R315 is not on the pre-approved list, and claims for a second assistant will be rejected without prior medical consultant authorization.
Billing Tips
- If performing this procedure for a trauma patient, ensure the ISS score is clearly documented in the chart and the E420 premium is submitted on the same claim record as R315 to avoid manual review delays.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
When claiming the trauma premium (E420), the medical record must list the Injury Severity Score (ISS).
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