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R436
R436 – Arthroplasty - Hand - interposition - multiple
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Multiple interposition arthroplasty of the hand is a surgical procedure for the treatment of arthritis or joint damage. It involves the reconstruction of multiple finger or thumb joints by placing a spacer, typically made of soft tissue or a synthetic material, between the damaged articular surfaces. This procedure aims to relieve pain and restore motion and stability to the affected joints.
When to Use
- Use R436 when performing a formal interposition arthroplasty on multiple joints within the hand, such as multiple MCP or PIP joint reconstructions using soft tissue or synthetic spacers.
- Select R436 instead of R435 (Arthroplasty - Hand - interposition - single) when the operative report clearly documents that more than one joint underwent the interposition procedure during the same session.
Common Pitfalls
- Billing R436 alongside individual joint codes (e.g., R489) for the same joints; R436 is intended to capture the multiple joint procedure, and unbundling will lead to claim rejection.
- Failing to document the specific joints involved; OHIP may audit to ensure the 'multiple' criteria are met, so specify each joint reconstructed in the operative note.
Billing Tips
- If the procedure is a revision of a previous arthroplasty, ensure you append the E564 premium to the R436 claim to receive the 35% fee increase.
Provider Fee$459.40
Specialist Fee$0.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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