R458 – Tibial shortening
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure listed under the Musculoskeletal System section. As a surgical procedure, payment is typically eligible for the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C). Assistant and anaesthetist fees are calculated based on basic and time units.
When to Use
- Use R458 specifically for planned tibial shortening osteotomies performed to correct limb length discrepancy or angular deformity.
- Do not use R458 for procedures primarily involving bone grafting or fixation of fractures; those require distinct codes such as R331 or R339.
Common Pitfalls
- Billing R458 alongside other musculoskeletal procedures on the same bone without applying the multiple procedure rule (50% reduction for subsequent procedures) will trigger an audit.
- Failure to document the specific indication for the shortening (e.g., limb length discrepancy measurement) often leads to claims being rejected during manual review.
Billing Tips
- Ensure the operative report clearly distinguishes the shortening procedure from any concurrent hardware removal or internal fixation to justify the full fee for R458.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Standard medical record requirements apply as per .
For anaesthesia involving extra units, the anaesthesiologist must determine and document the ASA level at the time of pre-operative anaesthesia assessment. See .
If claiming the Trauma Premium (E420), the medical record must list the Injury Severity Score (ISS). See .
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