R547 – Sacro-iliac joint
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Arthrotomy of the sacro-iliac joint is a surgical procedure that involves making an incision into the joint. This procedure is eligible for payment to the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C). The fee for the assistant is calculated based on 6 basic units plus time units. The fee for the anaesthesiologist is calculated based on 7 basic units plus time units. See and for details on fee calculations.
When to Use
- Use R547 for an open arthrotomy of the sacro-iliac joint, typically performed for drainage of infection or joint debridement.
- Select R547 when the procedure involves a formal surgical incision into the joint capsule, distinguishing it from percutaneous injections or diagnostic aspirations coded under different musculoskeletal sections.
Common Pitfalls
- Billing R547 alongside percutaneous sacro-iliac joint injections (e.g., Z212) is often flagged as unbundling if performed during the same operative session.
- Failure to document the specific surgical approach can lead to audit scrutiny, as R547 is strictly for arthrotomy; ensure the operative report clearly describes the joint incision.
Billing Tips
- Ensure the surgical assistant (suffix B) and anaesthesiologist (suffix C) claims are linked to the R547 procedure code to correctly trigger the base unit calculations of 6 and 7 units respectively.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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