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R409
R409 – Arthrotomy - Finger
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code encompasses various surgical procedures performed on the finger or finger joint. These include arthrotomy (surgical incision into a joint), open biopsy of the finger, and incision and drainage of a finger joint.
When to Use
- Use R409 for surgical incision and drainage of a finger joint when an infection or septic arthritis is present.
- Use R409 for performing an open biopsy of a finger joint to obtain tissue for diagnostic purposes.
- Use R409 for formal arthrotomy of a finger joint, distinct from simple aspiration or minor soft tissue procedures.
Common Pitfalls
- Do not bill R409 for simple needle aspiration of a joint; aspiration is generally considered part of an office visit or a lower-level procedure.
- Avoid billing R409 in conjunction with other finger surgical codes if the work is considered part of the same operative field or approach, as this may trigger a 'duplicate' or 'included' service rejection.
- Failure to document the specific joint involved and the surgical necessity for an open procedure (arthrotomy) versus a percutaneous approach can lead to audit recovery.
Billing Tips
- Ensure the operative report clearly describes an open incision into the joint space to justify the arthrotomy fee over minor procedural codes.
- If performing bilateral procedures or multiple procedures on the same finger, verify the Schedule of Benefits rules regarding multiple procedure logic to ensure correct payment of the secondary procedure.
Provider Fee$168.00
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
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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