R524 – Myositis ossificans
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R524 is a surgical procedure. The fee for the surgeon (suffix A) is a set amount. The fees for the assistant (suffix B) and anaesthesiologist (suffix C) are calculated based on a combination of basic units and time units, as detailed in the Surgical Assistants' Services () and Anaesthesiologists' Services () sections of the Schedule, respectively. The assistant service has 6 basic units. The anaesthesia service has 7 basic units.
When to Use
- Use R524 for the surgical excision of heterotopic ossification (myositis ossificans) when the primary clinical objective is the removal of the pathological bone formation.
- Select R524 when performing a formal surgical resection of symptomatic myositis ossificans that has matured, as opposed to simple soft tissue debridement.
Common Pitfalls
- Billing R524 in conjunction with other soft tissue procedures without clear documentation of separate incisions or distinct anatomical sites can lead to rejection for unbundling.
- Failure to document the specific anatomical location and the pathological nature of the ossified mass can trigger audit inquiries regarding the medical necessity of the procedure.
Billing Tips
- Ensure the surgical assistant (suffix B) and anaesthesiologist (suffix C) claims correctly reference the 6 and 7 basic units respectively, as these are mandatory for accurate unit-based fee calculation.
- When performing R524 after hours, ensure the appropriate premium (E409 or E410) is applied to the procedural fee, while separate assistant (E400B/E401B) and anaesthesia (E400C/E401C) premiums are applied to their respective service claims.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records establishing 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.
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