R440 – Total hip replacement - acetabulum and femur
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service code represents a total hip replacement arthroplasty, which includes the replacement of both the acetabulum (hip socket) and the femoral component (thighbone). As a major surgical procedure, it includes anaesthesia services (10 base units) and may involve a surgical assistant (8 base units). Payment for a second surgical assistant is also permitted for this procedure without requiring special authorization.
When to Use
- Use R440 for primary total hip arthroplasty involving the replacement of both the acetabular and femoral components.
- Select R440 for revision procedures that involve the complete replacement of both components, provided the criteria for a total hip replacement are met.
Common Pitfalls
- Billing R440 alongside R439 (hemiarthroplasty) is a common error; R440 is for total hip replacement, whereas R439 is for partial replacement.
- Failing to document the Injury Severity Score (ISS) in the medical record when appending the E420 trauma premium will result in automatic rejection.
- Attempting to bill a second surgical assistant as a separate claim without referencing the primary R440 procedure can lead to payment delays or denials.
Billing Tips
- When a second surgical assistant is required, bill them using the same procedure code R440 to ensure the system recognizes the eligibility for the second assistant payment without prior authorization.
- Ensure that any age-based premiums (e.g., for patients under 16) are calculated based on the patient's age at the time of the procedure and applied to the base fee of $708.70.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
If claiming the E420 trauma premium, the medical record must list the Injury Severity Score (ISS).
If a medical trainee is involved, specific documentation is required per .
Services where a second assistant's services are payable and authorization is not required: ... R440 ...
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