R424 – Synovectomy
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of the synovial membrane of the knee joint. This service is a surgical procedure and includes all common elements of an insured service as outlined in the Schedule of Benefits. The service is eligible for suffixes A (Surgeon), B (Assistant), and C (Anaesthetist). Anaesthesia: The anaesthesia fee is calculated using 7 base units plus time units as per rules on and . Surgical Assistant: The assistant fee is calculated using 6 base units plus time units as per rules on and .
When to Use
- Use R424 for a formal synovectomy of the knee joint as a standalone procedure or as the primary surgical focus.
- Use R424 when the procedure involves the excision of the synovial membrane, distinguishing it from simple arthroscopic debridement or lavage which may fall under different codes.
Common Pitfalls
- Claiming R424 alongside other knee procedures like R437 or R438 without clear documentation of separate, distinct surgical work will trigger a manual assessment by a Medical Consultant.
- Attempting to bill for a second surgical assistant is a common rejection; R424 is not pre-approved for a second assistant, and payment requires a formal letter of justification to the Ministry.
Billing Tips
- If performing R424 in conjunction with other musculoskeletal procedures on the same joint, ensure the operative report explicitly details the distinct nature of the synovectomy to avoid 'incidental procedure' denials.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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