R326 – Pseudoarthrosis - Tibia/fibula
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R326 is a surgical procedure listed in the Musculoskeletal System Surgical Procedures section of the Schedule of Benefits. The service is eligible for payment to the surgeon (suffix A), surgical assistant (suffix B), and anaesthetist (suffix C). As per , payment for a second assistant for R326 does not require prior authorization by a medical consultant. Payment for assistant and anaesthesia services is calculated based on basic and time units and is eligible for various after-hours and special visit premiums.
When to Use
- Use R326 specifically for the surgical treatment of established non-union (pseudoarthrosis) of the tibia or fibula.
- Select this code when the procedure involves formal surgical intervention to address the failure of bone healing in the lower leg, distinct from initial fracture fixation codes.
Common Pitfalls
- Billing R326 alongside initial fracture reduction codes; ensure the clinical documentation clearly supports the diagnosis of pseudoarthrosis rather than acute trauma management.
- Failing to document the specific necessity for a second assistant if claimed, although R326 is pre-authorized for a second assistant under GP90, the medical record must still justify the complexity requiring two assistants.
Billing Tips
- Ensure that if the procedure is performed after hours, you append the appropriate E-series premium (E409 or E410) to the procedural fee, as R326 is eligible for these enhancements.
- When claiming for a second assistant, ensure the claim is submitted with the appropriate suffix to avoid rejection, leveraging the pre-authorization status granted to R326 in the Schedule of Benefits.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
Services where a second assistant's services are payable and authorization is not required: D043, D046, D047, D052, D060, E645, F135, M112, M117, M134, M142, N539, N540, P042, P051, P052, P056, P059, R008, R009, R013, R014, R015, R016, R055, R056, R064, R065, R067, R069, R134, R135, R136, R140, R182, R240, R241, R244, R326, R327, R334, R393, R438, R440, R441, R483, R487, R545, R553, R568, R593, R594, R617, R645, R701, R702, R704, R712, R713, R714, R715, R718, R726, R727, R728, R729, R732, R733, R734, R735, R737, R742, R743, R746, R747, R749, R764, R770, R771, R772, R773, R774, R786, R799, R800, R801, R802, R803, R804, R811, R815, R817, R818, R830, R832, R858, R863, R870, R872, R874, R876, R927, R929, R920, R930, S005, S007, S079, S090, S091, S092, S096, S098, S099, S120, S125, S189, S210, S211, S213, S214, S267, S270, S271, S274, S275, S294, S295, S298, S300, S321, S416, S429, S440, S441, S453, S454, S462, S484, S750, S757, S758, S759, S816
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