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R432
R432 – Joint - open
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R432 is for an open biopsy of the joint of the elbow or forearm. This surgical procedure involves an incision to directly access and retrieve a tissue sample from the joint for pathological examination.
When to Use
- Use R432 for an open surgical biopsy of the elbow or forearm joint where an incision is made specifically to retrieve tissue for pathology.
- Select R432 when the procedure is an open approach, distinguishing it from percutaneous or needle-based biopsy techniques which are billed under different codes.
Common Pitfalls
- Do not bill R432 for arthroscopic biopsies, as these require specific arthroscopic procedure codes rather than open surgical codes.
- Avoid billing R432 in conjunction with other major joint procedures on the same site unless the biopsy is a distinct, separate incision and procedure, otherwise it may be considered part of the primary surgical fee.
- Failure to document the specific pathological indication for the open biopsy can lead to audit scrutiny regarding the necessity of an open approach versus a less invasive method.
Billing Tips
- Ensure the operative report clearly details the open incision and the specific joint space accessed to support the use of R432 over minor procedure codes.
- If the biopsy is performed as part of a larger, more complex joint surgery, verify if the Schedule of Benefits considers the biopsy an integral component of the primary procedure before billing R432 separately.
Provider Fee$171.45
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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