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R402
R402 – Ankle recurrent dislocation and/or subluxation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for the reduction of recurrent dislocation and/or subluxation of the ankle. As a surgical procedure, it includes all associated common and specific elements as defined in the General Preamble. This service is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees.
When to Use
- Use R402 for definitive surgical stabilization of chronic, recurrent ankle instability that has failed conservative management.
- Use this code for surgical procedures specifically addressing ligamentous or bony structural deficits causing recurrent subluxation, distinct from simple acute fracture management (e.g., D035 or D036).
Common Pitfalls
- Billing R402 for acute ankle fracture reduction is incorrect; acute fracture management should be billed under the appropriate fracture care codes like D035 or D036.
- Failure to document the 'recurrent' nature of the instability in the operative report can lead to audit rejections, as the code specifically covers recurrent dislocation or subluxation.
Billing Tips
- Ensure the operative report clearly details the specific surgical technique used for the stabilization, as R402 is a procedural code that encompasses the entire surgical event.
Provider Fee$367.45
Specialist Fee$0.00
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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