R328 – Pseudoarthrosis - Bone graft with or without external fixation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure on the urogenital system. The specific description for R328 is not available in the provided context. However, all surgical procedures include the common elements as defined on - and the following specific elements of surgery as defined on : - Preparing or supervising the preparation of the patient for the procedure. - Performing the procedure by any method, or assisting another physician in the performance of the procedure(s), assisting with the carrying out of all recovery room procedures and the transfer of the patient to the recovery room, and any ongoing monitoring and detention rendered during the immediate post-operative and recovery period, when indicated. - Making arrangements for any related assessments, procedures, or therapy (including obtaining any specimens from the patient) and/or interpreting results. - When medically indicated, monitoring the condition of the patient for post-procedure follow-up until the first post-operative visit. - Discussion with, and providing any advice and information, including prescribing therapy to the patient or the patient's representative, whether by telephone or otherwise, on matters related to the service.
When to Use
- Use R328 for the surgical management of a non-union fracture requiring bone grafting, specifically when the procedure involves the musculoskeletal system despite the classification label.
- Select R328 when performing a bone graft procedure for pseudoarthrosis that necessitates the application of external fixation hardware.
Common Pitfalls
- Do not bill R328 in conjunction with intramedullary nailing procedures for the femur, as those scenarios are specifically covered by E048.
- Avoid billing R328 for simple fracture reductions; it is strictly intended for established pseudoarthrosis requiring grafting, not acute fracture management.
Billing Tips
- Ensure the operative report explicitly details the bone graft technique and the use of external fixation to support the R328 claim during potential audits.
- Apply relevant surgical assistant premiums and after-hours procedure premiums to the R328 base fee when the specific criteria for those add-ons are met.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
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