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R426
R426 – Denervation - elbow
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Denervation of the elbow is a surgical procedure. General surgical rules and applicable premiums as outlined in the Schedule of Benefits may apply.
When to Use
- Use R426 for the surgical denervation of the elbow joint to address chronic pain refractory to conservative management.
- Use this code when performing a targeted nerve resection or ablation specifically localized to the elbow, distinguishing it from broader neurolysis or nerve decompression procedures.
Common Pitfalls
- Do not bill R426 in conjunction with other major elbow procedures without reviewing the Schedule of Benefits for multiple procedure rules, as this may trigger automatic reductions.
- Avoid billing R426 for simple nerve decompression or transposition; ensure the operative report explicitly describes the denervation technique to support the claim during an audit.
Billing Tips
- If a second surgical assistant is required, you must obtain prior authorization from a medical consultant, as R426 is not on the pre-approved list for automatic second assistant payment.
- Ensure the patient's age is verified against the age-based fee premiums, as R426 is eligible for percentage increases for patients under 16 years of age.
Provider Fee$258.00
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
Female Genital Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
Sex Restriction
Female
Payment for a second assistant requires authorization by a medical consultant as R426 is not on the pre-approved list for automatic payment of a second assistant.
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