R417 – Debridement of joint without synovectomy
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving debridement of the knee joint without synovectomy. This procedure is listed in the Musculoskeletal System section of the Schedule of Benefits. The fee for the surgeon (suffix A) is a flat rate. The fee for a surgical assistant (suffix B) is calculated using 6 base units plus time units, and the fee for an anaesthetist (suffix C) is calculated using 7 base units plus time units. Unit calculations are detailed in the General Preamble (- for assistant, - for anaesthesia).
When to Use
- Use R417 for arthroscopic debridement of the knee when the primary clinical objective is the removal of loose bodies or chondral flaps without the performance of a synovectomy.
- Select R417 when performing a limited debridement that does not meet the complexity or procedural requirements of more extensive procedures like a total synovectomy or complex ligamentous reconstruction.
Common Pitfalls
- Billing R417 in conjunction with a synovectomy code is a common audit trigger; if a synovectomy is performed, the higher-valued synovectomy code must be used instead.
- Attempting to bill a second surgical assistant without prior authorization will result in an automatic rejection, as R417 is not on the pre-approved list for two assistants.
- Failing to identify R417 as the 'major procedure' when performed with other surgeries can lead to incorrect base unit calculations for the anaesthetist and assistant.
Billing Tips
- Ensure the operative report explicitly describes the debridement performed to justify the code and distinguish it from diagnostic arthroscopy (R416) or synovectomy procedures.
- Apply the 10% age premium for patients aged 5 to 15 years to both the surgeon (suffix A) and the assistant (suffix B) fees to maximize the claim value.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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