R435 – Arthroplasty, hand, interposition, single
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for a single interposition arthroplasty of the hand. It is listed under the Musculoskeletal System Surgical Procedures section, within the Hand and Wrist subsection. The fee for this service provides 6 base units for a surgical assistant (Asst) and 7 base units for anaesthesia (Anae). See the General Preamble for rules on calculating total fees for assistant () and anaesthesia () services based on these units plus time.
When to Use
- Use R435 for a single interposition arthroplasty of a hand joint where a biological or synthetic spacer is inserted to maintain joint space.
- Use R435 when performing a single joint procedure that does not meet the criteria for a total joint replacement or when the specific interposition technique is the primary surgical intent.
Common Pitfalls
- Billing R435 multiple times for multiple joints is often rejected; use R489 when performing arthroplasty on multiple joints to ensure correct payment for the total procedure.
- Failing to document the revision status when applicable; you must append E564 to the R435 claim to receive the 35% fee increase for revision surgeries.
- Incorrectly calculating assistant or anaesthesia units by ignoring the major procedure rule; if performing multiple procedures, only the base units of the major procedure apply.
Billing Tips
- Always verify if the procedure qualifies for the E564 revision premium, as this is a significant fee adjustment that is frequently overlooked in secondary hand surgeries.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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