R410 – Arthrotomy - Wrist
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R410 is a surgical procedure listed in the OHIP Schedule of Benefits. It is used for Arthrotomy - Wrist, Biopsy - open wrist, and Incision and Drainage - Wrist joint. As a surgical code, it is eligible for assistant ('B' suffix) and anaesthetist ('C' suffix) services. Payment is also subject to various premiums based on patient age, time of day (after-hours), and clinical context (e.g., trauma), as outlined in the General Preamble.
When to Use
- Use R410 for an open surgical biopsy of the wrist joint when a needle biopsy is insufficient for diagnostic requirements.
- Use R410 for an open incision and drainage (I&D) of a septic wrist joint, provided the procedure is performed in an operating room setting.
- Use R410 for an open arthrotomy to remove loose bodies or perform a joint washout when arthroscopic intervention is not feasible or indicated.
Common Pitfalls
- Billing R410 in addition to a more comprehensive wrist procedure (e.g., R990 or R993) is considered 'unbundling' and will result in a rejection for duplicate services.
- Attempting to claim a hospital admission assessment or a subsequent visit on the same day as the R410 procedure will be rejected, as these are considered included in the surgical fee.
- Failure to document the Injury Severity Score (ISS) in the medical record will lead to the rejection of the E420 trauma premium if appended to the R410 claim.
Billing Tips
- Ensure the procedure is clearly identified as an 'open' procedure in the operative report to distinguish it from arthroscopic codes, which carry different fee values.
- If the procedure is performed after hours, ensure the claim includes the appropriate E409 or E410 premium code, ensuring the 'non-elective' status is documented to satisfy the General Preamble requirements.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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