R322 – Scaphoid
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical reconstruction for pseudoarthrosis, non-union, or avascular necrosis of the scaphoid bone. This service includes the necessary fixation and a non-vascularized bone graft as part of the procedure. An add-on code, E497, is payable if a pedicled vascularized bone graft is utilized.
When to Use
- Use R322 for the surgical reconstruction of a scaphoid non-union or pseudoarthrosis that requires internal fixation and a standard non-vascularized bone graft.
- Use R322 in conjunction with E497 when the surgical plan specifically incorporates a pedicled vascularized bone graft to address avascular necrosis of the scaphoid.
Common Pitfalls
- Billing F019 or Z279 on the same claim as R322 will result in an automatic rejection as these codes are explicitly restricted when performed in conjunction with scaphoid reconstruction.
- Failing to document the use of a bone graft in the operative report is a significant audit risk, as the fee for R322 assumes the inclusion of a non-vascularized graft as a mandatory component.
Billing Tips
- Ensure that if a pedicled vascularized bone graft is utilized, E497 is billed as an add-on to R322 to capture the additional $526.40 flat fee.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
1. R322 and R345 must include fixation and a non-vascularized bone graft.
2. E497 is payable in addition to R322 and R345 if a pedicled vascularized bone graft is used in addition to, or in place of a non-vascularized bone graft.
3. F019 and Z279 rendered in conjunction with R322 and R345 are not eligible for payment.
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