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R360
R360 – Major forefoot reconstruction
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Major forefoot reconstruction, must include the first MP joint and a minimum of 2 other MP joints. This surgical procedure is categorized under foot and ankle reconstruction and is listed in the Musculoskeletal System section of the Schedule of Benefits.
When to Use
- Use R360 for complex hallux valgus correction combined with osteotomies or arthrodesis of at least two lesser metatarsophalangeal joints.
- Use R360 for pan-metatarsal head resection or multi-joint reconstruction in cases of severe rheumatoid forefoot deformity.
Common Pitfalls
- Billing R360 when only the first MP joint is addressed; this is insufficient to meet the 'minimum of 2 other MP joints' requirement and will trigger a rejection.
- Attempting to bill individual lesser toe osteotomies or arthroplasties in addition to R360; the code is comprehensive for the forefoot and includes the required multi-joint work.
- Failure to clearly document the involvement of the first MP joint plus two additional MP joints in the operative report, which is the primary target for post-payment audits.
Billing Tips
- Ensure the operative report explicitly names the first MP joint and the two specific lesser MP joints involved to satisfy the Schedule of Benefits criteria.
- If performing a bilateral procedure, ensure the second side is billed with the appropriate bilateral indicator (e.g., suffix 'A' with the 'B' indicator) to ensure correct payment for the second foot.
Provider Fee$711.15
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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