R578 – Suture extensor tendon and/or open repair acute or chronic boutonniere deformity
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code is for a surgical procedure on the cardiovascular system. The surgeon's fee (suffix 'A') is a global fee that includes the major pre-operative visit (the consultation or assessment where the decision to operate is made and scheduled) and normal post-operative care. Fees for assisting at surgery (suffix 'B') and anaesthesia (suffix 'C') are calculated based on a combination of basic units and time units as described in the Schedule of Benefits (see to ).
When to Use
- Use R578 for the formal surgical repair of a central slip injury resulting in a boutonniere deformity, whether the presentation is acute or chronic.
- Select R578 when performing an open surgical procedure to re-establish the extensor mechanism continuity at the proximal interphalangeal (PIP) joint.
Common Pitfalls
- Do not bill R578 for simple closed reductions or splinting of finger injuries, as these are not surgical repairs.
- Avoid billing R578 in combination with other hand surgery codes unless distinct, separate incisions or anatomical sites are involved, as this may trigger a multiple procedure rule reduction.
- Failure to document the specific nature of the deformity (acute vs. chronic) and the surgical technique used can lead to audit scrutiny regarding medical necessity.
Billing Tips
- Ensure the operative report clearly details the extensor tendon repair to support the R578 claim, as this code is specific to the extensor mechanism.
- If the procedure is performed on an emergency basis after hours, ensure the appropriate E-series premium is applied to the surgical fee to maximize the claim value.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Cardiovascular Surgical Procedures
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
The specific title, description, and some fee calculation details (such as assistant base units) for this code are not available in the provided context, as the specific section page was not included. This record is based on general rules for surgical procedures outlined in the General Preamble.
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