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R562
R562 – Tenotomy of hamstrings - multiple
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving multiple tenotomies of the hamstring muscles. This procedure is eligible for payment to the surgeon (suffix A), an assistant (suffix B), and an anaesthetist (suffix C). The assistant fee is calculated based on 6 base units plus time units. The anaesthetist fee is calculated based on 6 base units plus time units. Refer to - and - for detailed calculation rules.
When to Use
- Use R562 when performing multiple hamstring tenotomies during a single surgical session, as it is specifically designated for multiple procedures.
- Use R562 instead of R543 when the surgical plan involves releasing multiple hamstring tendons rather than a single isolated tenotomy.
Common Pitfalls
- Billing R562 alongside other hamstring procedures is often rejected as a duplicate or bundled service; ensure the claim reflects the 'multiple' nature of the code.
- Failing to document the specific number and location of the tenotomies can lead to audit recovery, as the 'multiple' designation requires anatomical specificity in the operative report.
Billing Tips
- Always verify if the patient qualifies for age-based premiums (e.g., AGE_PREMIUM_5-16Y), as these apply to both the surgeon and the surgical assistant fees for this code.
- When billing for the anaesthetist, ensure that extra units for ASA physical status or patient positioning are calculated separately from the 6 base units to maximize the anaesthesia claim.
Provider Fee$193.00
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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