R341 – Tibial and femoral epiphysiodesis
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure within the Musculoskeletal System section of the Schedule of Benefits. As a surgical procedure, payment includes pre-operative, intra-operative, and post-operative care as defined in the General Preamble. Specific details regarding the exact nature of this procedure are not available in the provided context, but it is subject to all general rules for surgical procedures, including allowances for assistants, anaesthesia, and various premiums for after-hours services, specific patient age groups, and trauma cases.
When to Use
- Use R341 for the surgical arrest of epiphyseal growth in the tibia or femur to correct limb length discrepancy or angular deformity.
- Select R341 when performing a percutaneous or open epiphysiodesis procedure, ensuring the operative report clearly defines the specific bones addressed.
Common Pitfalls
- Billing R341 in conjunction with a separate consultation or hospital admission assessment; these are considered part of the global surgical fee unless the visit is the designated major pre-operative assessment.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium, which leads to automatic rejection or recovery upon audit.
Billing Tips
- Apply the appropriate age-based premium (e.g., AGE_PREMIUM_UNDER_16_YEARS) to the R341 fee, as this procedure is most commonly performed on pediatric patients within specific age brackets.
- If the procedure is performed bilaterally or on multiple sites, ensure the claim reflects the correct number of units or modifiers as per the Schedule of Benefits to avoid underpayment.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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