R473 – Radius and ulna
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure within the Musculoskeletal System section of the OHIP Schedule of Benefits. As a surgical procedure, payment for the surgeon (suffix A) typically includes pre-operative and post-operative care. Payment for an assistant (suffix B) and anaesthetist (suffix C) is calculated using a system of basic units plus time-based units. See the unitBasedInfo section and notes for details on fee calculation. The service is eligible for various add-on premiums, including for patient age, after-hours service, and trauma, subject to specific criteria outlined in the General Preamble.
When to Use
- Use R473 for open reduction and internal fixation (ORIF) of combined radius and ulna fractures, which is distinct from isolated radial (R470) or ulnar (R471) shaft procedures.
- Select this code when performing surgical stabilization of both bones in the forearm through a single or dual incision approach during the same operative session.
Common Pitfalls
- Billing R473 alongside R470 or R471 is a common error; R473 is a comprehensive code and already accounts for the complexity of addressing both bones.
- Failure to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium will result in automatic rejection during audit.
- Attempting to bill a second surgical assistant without prior authorization; R473 is not on the pre-approved list for multiple assistants, requiring manual approval.
Billing Tips
- Ensure the operative report explicitly details the fixation of both the radius and the ulna to justify the use of the combined code over single-bone alternatives.
- If the procedure is delayed due to an intervening emergency, ensure the start time is clearly noted to support the application of E409 or E410 premiums.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Anaesthesia Extra Units (for 'C' suffix): Extra units may be payable in addition to basic units for anaesthesia under specific circumstances such as patient age, BMI > 40, prone position, malignant hyperthermia risk, high ASA classification, or emergency surgery. Refer to for a full list of applicable codes (e.g., E010C, E011C, E018C, E022C).
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