R355 – Hallux valgus reconstruction
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the correction of a hallux valgus deformity, often referred to as a bunion. This service listing provides examples of specific techniques, such as the Joplin or McBride procedure. It is categorized under 'Reconstruction' for the foot and ankle within the Musculoskeletal System section of the Schedule.
When to Use
- Use R355 for standard hallux valgus reconstruction involving osteotomy, soft tissue balancing, or tendon transfers.
- Use R355 when performing a McBride or Joplin procedure for bunion correction as explicitly listed in the Schedule.
- Use R355 when the procedure includes integrated components like tenotomy, soft tissue plication, or MTP joint debridement performed during the same operative session.
Common Pitfalls
- Do not bill R355 for excisional arthroplasty; these must be claimed specifically as R309 or E587 to avoid rejection.
- Avoid unbundling; R355 includes soft tissue releases and synovectomy, so billing these separately as additional procedures will result in claim rejection.
- Failure to distinguish between reconstruction (R355) and excision (R309/E587) is a frequent audit trigger for orthopedic claims.
Billing Tips
- Ensure the operative report clearly describes the reconstruction technique used to support the R355 code over an excisional arthroplasty code.
- When performing bilateral procedures, apply the appropriate multiple procedure payment rules to the assistant and anaesthesia units as defined in the Schedule.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The Act requires that the medical 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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