R422 – Synovectomy and debridement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the excision of the synovial membrane (synovectomy) and debridement of a joint in the shoulder, arm, or chest. This service is identified with a '#' prefix, indicating that for services performed in a hospital or an Integrated Community Health Services Centre (ICHSC), the costs for premises, equipment, supplies, and personnel are funded by that facility's budget and are not billed separately by the physician (see on ).
When to Use
- Use R422 for open synovectomy and debridement of the shoulder joint when arthroscopic codes like R425 are not applicable or the procedure is performed via open approach.
- Use R422 when performing a formal excision of the synovial membrane combined with joint debridement in the arm or chest region, provided it does not fall under more specific joint-specific codes.
- Use R422 as the primary procedure code when debridement of the joint is the main surgical objective alongside the synovectomy.
Common Pitfalls
- Billing R422 in conjunction with other joint-specific debridement codes may result in rejection for unbundling; ensure the procedure is distinct and not part of a more comprehensive surgical package.
- Attempting to bill for a second assistant without prior authorization will lead to automatic rejection, as R422 is not on the pre-approved list for second assistants.
- Failing to account for the '#' prefix rules by attempting to bill facility-related costs separately will result in audit flags and recovery of funds.
Billing Tips
- If performing multiple procedures under the same anaesthetic, ensure the assistant fee (suffix B) and anaesthesia units (suffix C) are correctly linked to the major procedure code to avoid payment adjustments.
- If the surgery is cancelled after anaesthesia induction but before commencement, bill E006B for the assistant or E006C for the anaesthetist rather than attempting to claim R422.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The '#' prefix indicates this service has special funding arrangements for facility costs in hospitals and ICHSCs (see ).
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