R429 – Meniscectomy
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Meniscectomy is a surgical procedure for the excision of the meniscus of the knee. This procedure is listed in the Musculoskeletal System section of the Schedule of Benefits under the 'Knee - Excision' subsection. It is eligible for surgeon (R429A), assistant (R429B), and anaesthetist (R429C) services, with specific unit calculations for the assistant and anaesthetist as outlined in the General Preamble. Various premiums for after-hours, age, and trauma may apply to the surgeon's fee, while separate premiums apply for assistant and anaesthesia services.
When to Use
- Use R429 for the surgical excision of a torn meniscus during arthroscopic or open knee surgery.
- Select R429 when performing a partial or total meniscectomy, as it is the primary code for this specific excision procedure.
Common Pitfalls
- Do not bill R429 in conjunction with R431 (meniscal repair) on the same meniscus, as this is considered unbundling or double-dipping for the same anatomical site.
- Avoid billing R429 alongside R417 (arthroscopy) as a separate procedure, as the arthroscopic approach is considered inclusive to the R429 fee.
Billing Tips
- Ensure the operative report clearly specifies the extent of the excision to justify the use of R429 over diagnostic arthroscopy codes.
- If a second assistant is required for a complex case, you must obtain prior authorization from a medical consultant, as R429 is not on the pre-approved list for secondary assistance.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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