R517 – Foreign body removal
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R517 is a fee code for a surgical procedure performed on the musculoskeletal system. The surgeon's fee is payable using suffix A. Anaesthesia services (suffix C) are payable based on basic and time units. Surgical assistant services (suffix B) are not payable for this procedure, as indicated by a 'nil' or 0.00 fee for the assistant in the Schedule.
When to Use
- Use R517 for the surgical removal of a foreign body embedded in musculoskeletal tissue that requires an incision and formal operative technique.
- Select R517 when the procedure is distinct from a simple superficial skin foreign body removal, which would typically be billed under a minor surgery code like Z001.
Common Pitfalls
- Attempting to bill a surgical assistant (suffix B) for this procedure will result in a rejection, as the Schedule explicitly lists the assistant fee as nil.
- Billing R517 in conjunction with a visit code (e.g., A007) for the same encounter is a common audit trigger; ensure the service meets the criteria for a separate surgical procedure if billing both.
Billing Tips
- If the procedure is performed in an emergency setting outside of scheduled hours, ensure you append the appropriate After Hours Procedure Premium (E409 or E410) to the R517A claim to maximize the procedural fee.
- Always document the specific anatomical location and the depth of the foreign body to justify the use of a musculoskeletal surgical code over a minor dermatological procedure.
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. The Act requires that the record establish that: an insured service was provided; the service for which the account is submitted is the service that was rendered; and the service was medically necessary.
Surgical assistant is not payable.
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