R569 – Abductor tendon transfer
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Tendon transfer of the abductor muscle is a surgical procedure listed in the Musculoskeletal System section of the Schedule of Benefits. This procedure is eligible for payment to the surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C). The fee calculation for assistants and anaesthesiologists is unit-based, with 6 basic units assigned for each service, plus time units. See - and - for detailed calculation rules.
When to Use
- Use R569 for the surgical transfer of an abductor tendon to restore hip stability or function, distinguishing it from R570 which covers different musculoskeletal procedures.
- Apply this code when the procedure is performed as a standalone surgical intervention for tendon relocation or reattachment in the hip region.
Common Pitfalls
- Billing R569 alongside other musculoskeletal procedures without ensuring they are not considered 'incidental' or 'included' under the Schedule of Benefits, which leads to automatic claim rejection.
- Failing to document the specific anatomical site and the nature of the transfer, which is required to justify the surgical fee during post-payment audits.
Billing Tips
- Ensure that if a surgical assistant (suffix B) or anaesthesiologist (suffix C) is present, their claims are submitted with the correct basic and time units as defined in GP85 and GP92 to avoid payment discrepancies.
- Verify the patient's age at the time of the procedure to automatically apply the correct Age Premium (e.g., under 16, under 5, etc.) to the surgeon's fee, as these are not always applied by default.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.