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R342
R342 – Tibial stapling - one side
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Tibial stapling - one side
When to Use
- Use R342 for the surgical placement of staples across the physis for hemiepiphysiodesis on one side of the tibia to correct angular deformity.
- Use this code specifically when performing a unilateral procedure; if performing bilateral tibial stapling, you must bill R342 with the appropriate bilateral indicator or modifier as per the Schedule of Benefits.
Common Pitfalls
- Billing R342 as a bilateral procedure without using the correct bilateral modifier will lead to an automatic rejection or underpayment.
- Attempting to bill R342 in conjunction with other epiphysiodesis codes (e.g., R343) for the same limb segment without clear documentation of distinct, separate surgical sites will trigger a claim audit.
- Failure to document the specific side (left or right) in the operative report often leads to claim rejection during manual review.
Billing Tips
- Always verify if the patient qualifies for age-based premiums, as pediatric patients undergoing this procedure frequently meet the criteria for the 10% to 30% surgical fee increases.
- If a second surgical assistant is required, you must submit a formal letter of justification to the Ministry, as R342 does not carry automatic approval for second assistant billing.
Provider Fee$193.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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