R317 – Dorsal exostosis (triquetrum)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Dorsal exostosis (triquetrum) is a surgical procedure for the excision of a bony growth from the dorsal aspect of the triquetrum bone in the wrist. This service is eligible for payment for the operating surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C). The fee for the surgeon is a set amount. The fees for the assistant and anaesthetist are calculated based on a combination of basic units and time units. **Assistant Service (R317B)** - Base Units: 6 - Time Unit Calculation: Time units are calculated for each 15 minutes or part thereof. The unit value is 1 unit per increment for the first hour or less, 2 units per increment after the first hour up to and including the first 1.75 hours, and 3 units per increment after 1.75 hours (as per ). **Anaesthesia Service (R317C) - Base Units: 6 - Time Unit Calculation: Time units are calculated for each 15 minutes or part thereof. The unit value is 1 unit per increment for the first hour, 2 units per increment after the first hour up to 1.5 hours, and 3 units per increment after 1.5 hours (as per ). As a surgical procedure, this service includes the constituent and common elements of insured services as outlined in and .
When to Use
- Use R317 when performing a formal excision of a symptomatic dorsal triquetral exostosis that has failed conservative management.
- Select R317 over R316 (excision of ganglion) when the primary pathology is a bony prominence rather than a cystic lesion.
Common Pitfalls
- Billing R317 alongside R285 or R286 for the same wrist is considered duplicate billing for the same anatomical site and will trigger a rejection.
- Failure to apply the multiple procedure rule when performing R317 in conjunction with other wrist procedures leads to overpayment and audit recovery; only the major procedure's base units apply.
Billing Tips
- Ensure the operative report explicitly documents the excision of bone rather than just soft tissue to support the use of R317 over general excision codes.
- When billing R317C, ensure time units are calculated precisely from induction to emergence to avoid discrepancies with the hospital's anaesthesia record.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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