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R561
R561 – Ilio-tibial band
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
An open surgical procedure on the ilio-tibial band, listed under the 'Muscles/tendons' reconstruction subsection for the femur. This procedure is distinct from the closed release of the ilio-tibial band, which is billed using Z197.
When to Use
- Use R561 for open surgical reconstruction or lengthening of the ilio-tibial band, typically involving formal incision and tissue manipulation.
- Select R561 when the procedure involves an open approach to address chronic ilio-tibial band syndrome that has failed conservative management and closed release (Z197).
Common Pitfalls
- Do not bill R561 for closed releases or percutaneous procedures, as these must be billed under Z197.
- Avoid billing R561 as a second assistant procedure without prior authorization, as it is not on the pre-approved list for second assistant claims.
Billing Tips
- Ensure the operative report clearly describes an open surgical approach to support the use of R561 over the lower-valued Z197.
- When performing bilateral procedures or multiple surgeries, remember that assistant and anaesthesia units are restricted to the major procedure only.
Provider Fee$190.10
Surgical Assistant Fee$75.06
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
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