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R555
R555 – Achilles or tibialis anterior/posterior tenotomy - closed
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A closed surgical tenotomy of the Achilles or tibialis anterior/posterior tendon, as listed in the Musculoskeletal System Surgical Procedures section of the Schedule on page . This procedure involves cutting the tendon without a large, open incision.
When to Use
- Use for a percutaneous tenotomy of the Achilles tendon, typically performed for equinus deformity correction in pediatric patients.
- Use for closed tenotomy of the tibialis anterior or posterior tendons when performed without an open surgical incision.
Common Pitfalls
- Billing R555 for an open procedure; open tenotomies are distinct and require different codes from the musculoskeletal section.
- Attempting to bill a surgical assistant fee; R555 is explicitly ineligible for payment for a surgical assistant.
Billing Tips
- Ensure the procedure is documented as closed or percutaneous to justify the use of R555 over open surgical codes.
- If the procedure is performed on a trauma patient, ensure the Injury Severity Score (ISS) is documented in the chart to support the E420 trauma premium.
Provider Fee$132.70
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
For payment of the E420 trauma premium, the medical record must list the Injury Severity Score (ISS).
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