R332 – Femoral lengthening
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Femoral lengthening is a surgical reconstruction procedure performed on the femur to correct leg length discrepancy. As a surgical service, it is eligible for payment to the performing surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C). The fees for the assistant and anaesthesiologist are calculated based on a combination of basic units assigned to the procedure and time units based on the duration of their attendance. Various premiums may apply, including for after-hours service, age of the patient, and in cases of significant trauma.
When to Use
- Use R332 for formal femoral lengthening procedures, such as those involving distraction osteogenesis, to address significant limb length discrepancy.
- Select R332 when the primary surgical intent is the elongation of the femur, distinguishing it from simple fracture fixation or osteotomy codes like R340 or R341.
Common Pitfalls
- Attempting to bill a second surgical assistant for R332 will result in rejection, as it is not an automatically approved procedure for multiple assistants and requires prior medical consultant authorization.
- Failing to document the Injury Severity Score (ISS) in the medical record will lead to the automatic rejection of the E420 trauma premium, even if the procedure was performed within the 24-hour window.
- Incorrectly applying after-hours premiums (E409/E410) to elective femoral lengthening cases; these premiums are strictly reserved for non-elective procedures or elective cases delayed by an intervening surgical emergency.
Billing Tips
- Ensure the age-based premium (e.g., 5-16 years) is applied to both the surgeon (A suffix) and the assistant (B suffix) claims to maximize eligible reimbursement for pediatric patients.
- When billing the E420 trauma premium, ensure the claim is submitted simultaneously with the R332 procedure code to avoid processing errors.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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