R437 – Wrist arthroplasty - interposition
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Interposition arthroplasty of the wrist. This surgical procedure involves reshaping the wrist joint and placing soft tissue (such as a tendon or fascia) between the bones to create a new, smooth joint surface. This service includes the surgeon's fee, as well as separate calculations for anaesthesia (-) and assistant (-) services based on base units and time units. May be eligible for a revision premium (E564).
When to Use
- Use R437 when performing a formal interposition arthroplasty of the wrist using autologous or synthetic soft tissue spacers to address symptomatic arthritis.
- Select R437 specifically for interposition techniques; do not use this code for total wrist arthroplasty (e.g., R435 or R436) or simple synovectomy/debridement procedures.
Common Pitfalls
- Billing R437 in combination with R285 or R316 will trigger an automatic rejection due to explicit billing restrictions.
- Failing to document the revision status when claiming E564, or attempting to claim E564 for a primary procedure, will lead to audit recovery.
Billing Tips
- Ensure the 35% revision premium E564 is appended to the R437 claim when the procedure is a revision of a prior wrist arthroplasty, provided it is not billed with R694.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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