R541 – Flexor tenolysis with pulley preservation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Flexor tenolysis with pulley preservation is a surgical procedure performed on the hand or wrist. As an insured surgical service, it includes all common elements such as patient assessment, obtaining consent, documentation, and post-operative follow-up. Specific to the surgery, it includes the anaesthetic, the surgical procedure itself (releasing the flexor tendon while preserving the pulley), and post-operative care until the first post-operative visit, as detailed in the and .
When to Use
- Use R541 when performing a secondary procedure to release adhesions around a previously repaired flexor tendon while specifically maintaining the integrity of the annular pulley system.
- Select R541 instead of R575 when the surgical objective is limited to tenolysis rather than a primary tendon repair or reconstruction.
Common Pitfalls
- Billing R541 in conjunction with other hand surgery codes without applying the multiple procedure rule, which requires the secondary procedure to be reduced to 85% of the fee.
- Attempting to bill an additional fee for the pulley preservation, which is already considered an integral component of the R541 procedure and not separately billable.
Billing Tips
- Ensure the operative report explicitly details the release of adhesions and the preservation of the pulley to justify the use of R541 over a general tenolysis code.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The medical record must 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.
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