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R413
R413 – Osteochondritis dissecans with drilling and/or internal fixation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Arthrotomy of the knee for the treatment of osteochondritis dissecans. The procedure involves drilling and/or the use of internal fixation. This service is performed under anaesthesia.
When to Use
- Use R413 when performing an arthrotomy specifically for the drilling of an osteochondritis dissecans lesion to promote revascularization.
- Use R413 when internal fixation, such as the placement of pins or screws, is required to stabilize an osteochondritis dissecans fragment within the knee joint.
Common Pitfalls
- Billing R413 in conjunction with other knee arthroscopy codes (e.g., N285) for the same joint during the same session is a common cause of rejection due to the 'multiple procedure' rule.
- Failing to document the specific use of drilling or internal fixation in the operative report, which is required to justify the R413 fee over a standard arthrotomy code.
Billing Tips
- Ensure the operative note explicitly details the fixation hardware used or the drilling technique employed, as this is the primary clinical justification for the R413 code.
- If performing bilateral procedures, remember that the anaesthesiologist and surgical assistant fees are governed by the 'major procedure only' rule, limiting the units claimed for the second procedure.
Provider Fee$267.25
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
All insured services must be documented in appropriate records that establish the service was provided, is the service for which the account is submitted, and was medically necessary. See .
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