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R572

R572Tenodesis

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

R572 is a surgical procedure for tenodesis, which is the fixation of a tendon. It is listed in the 'Foot and Ankle' subsection of the 'Musculoskeletal System Surgical Procedures' section. The service includes allowances for a surgical assistant and anaesthesia, with specific basic units assigned for calculating their respective fees as per the Schedule of Benefits.

When to Use

  • Use R572 for the surgical fixation of a tendon to bone in the foot or ankle, distinct from simple tendon repairs like R556 or R557.
  • Select R572 when performing a formal tenodesis procedure as part of a reconstructive foot or ankle surgery, rather than a primary tendon transfer or tenorrhaphy.

Common Pitfalls

  • Claiming R572 alongside other major foot/ankle procedures without acknowledging the payment adjustment rule, which restricts assistant and anaesthesia units to the major procedure only.
  • Failing to document the specific Injury Severity Score (ISS) in the medical record when appending the E420 trauma premium, leading to automatic rejection upon audit.
  • Incorrectly billing R572 for simple tendon repairs that are more appropriately coded under other musculoskeletal repair codes.

Billing Tips

  • Ensure the surgical assistant (R572B) and anaesthetist (R572C) record exact start and end times in the chart, as these are mandatory for calculating time-based units.
  • When performing bilateral procedures, remember that the Schedule of Benefits limits the assistant and anaesthesia basic units to the major procedure only, even if R572 is performed on both sides.
Provider Fee$338.10
Surgical Assistant Fee$77.46
Anaesthetist Fee$111.72
Non-Anaesthetist Fee$111.72

Effective: April 1, 2026

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services

For assistant (R572B) and anaesthesia (R572C) services, the start and end times must be recorded in the patient's medical record to calculate time units.

When claiming the Trauma Premium (E420), the Injury Severity Score (ISS) must be listed in the medical record.

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