R548 – Extensive/multiple repair - wrist
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R548 is a surgical procedure listed under the Musculoskeletal System section of the Schedule of Benefits. The service is eligible for payment to the operating surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C) as per . The fee for the surgical assistant is calculated by adding basic units and time units, and multiplying the total by the unit fee as detailed on pages -. The fee for the anaesthesiologist is similarly calculated by adding basic and time units and multiplying by the unit fee as detailed on pages -. Payment for a second assistant requires special authorization ().
When to Use
- Use R548 for complex, multi-tendon, or multi-ligament repairs in the wrist that exceed the scope of simple primary repair codes.
- Select R548 when the operative report clearly details extensive tissue reconstruction or multiple distinct repair sites within the wrist joint or carpal tunnel region.
Common Pitfalls
- Billing R548 alongside other specific tendon or ligament repair codes for the same anatomical site is a common cause of rejection for unbundling.
- Failing to provide the required operative report documentation justifying the 'extensive' nature of the repair often leads to audit recovery or claim rejection.
Billing Tips
- Ensure the surgical assistant (suffix B) and anaesthesiologist (suffix C) claims are linked to the primary R548 code to ensure correct unit-based fee calculation.
- If the procedure is performed as an emergency, ensure the appropriate after-hours or trauma premiums are applied to the procedural fee, not just the assistant or anaesthesia units.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Submit claims for assisting at surgery using the suffix 'B', with the procedural code.
Submit claims for anaesthesia services rendered with a surgical procedure using the suffix 'C', with the procedural code.
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