R570 – Iliopsoas tendon transfer
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Tendon transfer of the Iliopsoas is a reconstructive surgical procedure performed on the pelvis and hip. Payment for this service includes all common and specific elements of a surgical procedure, such as the pre-operative evaluation, the operation itself, and normal post-operative care. Anaesthesia and surgical assistant services are eligible for separate payment based on basic and time units as defined in the Schedule of Benefits. Refer to pages - for surgical assistant rules and - for anaesthesiologist rules.
When to Use
- Use R570 specifically for the surgical transfer of the iliopsoas tendon, typically performed to address hip flexion contractures or as part of complex reconstructive hip procedures.
- Select R570 when the primary intent of the procedure is the mechanical transfer of the tendon, distinguishing it from general soft tissue releases like R545 or R521.
Common Pitfalls
- Billing R570 in conjunction with other hip procedures without ensuring the claim reflects the 'multiple procedure' rule, which may lead to automatic reductions if not properly coded.
- Failure to document the specific anatomical indication for the transfer, which is a common trigger for post-payment audits regarding the medical necessity of R570 versus simpler release procedures.
Billing Tips
- Ensure that if R570 is performed bilaterally, the second procedure is billed with the appropriate 'B' suffix or modifier to trigger the correct 50% reduction for the second side.
- Always verify if the patient meets the age-based premium criteria (e.g., AGE_PREMIUM_U16Y) as these are often missed on surgical claims for pediatric hip reconstructions.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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