R339 – Tibial epiphysiodesis
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
The full description incorrectly states the category as 'Urogenital System'. It should be 'Musculoskeletal System Surgical Procedures' as per the heading on page . The rest of the description regarding suffixes, fee calculation, premiums, and second assistant authorization is consistent with the general preamble pages.
When to Use
- Use R339 for the surgical arrest of growth at the proximal or distal tibial physis to correct limb length discrepancy or angular deformity.
- Use this code for epiphysiodesis procedures performed via open surgical technique, distinct from percutaneous guided growth procedures which may require different coding.
Common Pitfalls
- Billing R339 as a bilateral procedure without the appropriate suffix (e.g., B for bilateral) will result in an automatic rejection or underpayment.
- Failing to document the specific physis treated (proximal vs. distal) in the operative report can lead to audit failures, as the code description is generic.
Billing Tips
- Ensure the patient's age is clearly documented, as R339 is highly sensitive to the age-based premiums (Parts K to Z) which significantly increase the base fee for pediatric patients.
- When performing multiple procedures during the same session, ensure the primary procedure is billed at 100% and secondary procedures are billed at 85% or 50% according to the Multiple Procedure Rule.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
Standard medical record requirements as per the Health Insurance Act must be met, including documentation to establish that the service was provided, medically necessary, and is the service for which the claim is submitted.
An operative report is typically required for surgical procedures.
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