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R499
R499 – Removal of total replacement
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Removal of a total replacement of the elbow. This procedure is listed in the Schedule of Benefits under the Musculoskeletal System section, specifically for the elbow and forearm arthroplasty.
When to Use
- Use R499 specifically for the complete removal of a total elbow arthroplasty prosthesis, typically in cases of infection or aseptic loosening.
- Do not use R499 for simple component revisions or partial removals; it is reserved for the removal of the total replacement system.
Common Pitfalls
- Billing R499 in conjunction with a subsequent reimplantation procedure may trigger a rejection if the reimplantation code is considered inclusive of the removal.
- Failure to document the specific indication (e.g., infection, mechanical failure) often leads to audit inquiries regarding the necessity of the total removal versus a partial revision.
Billing Tips
- Ensure that if a spacer is inserted during a two-stage revision, the insertion of the spacer is billed using the appropriate separate code, as R499 only covers the removal component.
Provider Fee$402.75
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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