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R499

R499Removal 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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