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R558
R558 – Open reduction - late
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction of a late dislocation of the radial head. This is a surgical procedure performed on the elbow and forearm. The fee for this service is for the surgeon (suffix A). Services for a surgical assistant (suffix B) and an anaesthesiologist (suffix C) are calculated separately based on basic and time units.
When to Use
- Use R558 specifically for the open reduction of a radial head dislocation that is considered 'late' or chronic, distinguishing it from acute reductions billed under R540.
- Apply this code when the surgical approach requires formal open exposure to address established fibrous tissue or malunion in a radial head dislocation.
Common Pitfalls
- Billing R558 for an acute, closed, or simple reduction procedure, which should be billed under alternative musculoskeletal codes like R540.
- Failing to document the 'late' nature of the dislocation, which is a prerequisite for the R558 fee, potentially leading to audit recovery if the clinical notes only describe an acute injury.
- Incorrectly appending after-hours premiums (E409/E410) to elective procedures that were not delayed by an intervening surgical emergency.
Billing Tips
- If the procedure is performed as a trauma case, ensure the Injury Severity Score (ISS) is documented in the operative report to support the E420 trauma premium.
Provider Fee$357.20
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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