R577 – Boutonniere - open
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R577 is a fee code for a surgical procedure listed in the Musculoskeletal System section of the OHIP Schedule of Benefits. Payment is made based on the role of the physician, indicated by a suffix: - Suffix A (Surgeon): The fee for the surgeon who personally performs the procedure. This service includes all common elements of insured services as described in -. - Suffix B (Assistant): The fee for the physician assisting at the surgery. The fee is calculated by adding basic units and time units. Specific elements for an assistant's service are outlined in . - Suffix C (Anaesthetist): The fee for the physician administering the anaesthetic. The fee is calculated by adding basic units and time units. Specific elements for an anaesthetist's service are outlined in . Various premiums for after-hours services, special visits, and patient-specific conditions (e.g., age, complexity, trauma) may be billed in addition to the primary procedural fee as outlined in the General Preamble.
When to Use
- Use R577 for the open surgical repair of a Boutonniere deformity involving the central slip of the extensor tendon.
- Select R577 when the procedure requires formal open exposure and reconstruction of the extensor mechanism, rather than simple percutaneous pinning or closed splinting.
Common Pitfalls
- Billing R577 alongside other hand surgery codes without checking for Schedule of Benefits 'multiple procedure' rules, which may result in a 50% reduction for the second procedure.
- Attempting to bill a second surgical assistant for R577 without prior approval from a medical consultant, as it is not on the pre-authorized list for multiple assistants.
Billing Tips
- Ensure the operative report explicitly details the open nature of the repair to support the use of R577 over non-surgical or percutaneous codes.
- If the procedure is performed on an emergency basis after hours, append the appropriate non-elective premium (E409A or E410A) to the R577 claim to increase the procedural fee by 50% or 75% respectively.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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