R581 – Tenotomy - more than one toe
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open tenotomy for more than one toe. This is a surgical procedure involving the incision and division of multiple tendons in the toes. Payment for a surgical assistant is not standard and requires independent consideration. Anaesthesia services are paid based on a unit system combining base units and time units.
When to Use
- Use R581 when performing an open tenotomy on two or more toes during the same operative session.
- Use this code for multi-toe procedures where R579 (Tenotomy - single toe) would be insufficient to capture the complexity of the surgical intervention.
Common Pitfalls
- Billing R581 alongside R579 for the same foot is considered unbundling and will result in a rejection.
- Assuming surgical assistant fees are automatically payable; R581 does not have assigned assistant units, requiring a manual submission via M400B with supporting documentation.
- Failing to document the specific number of toes treated, which is essential for audit justification of the 'more than one' requirement.
Billing Tips
- If a surgical assistant is required, submit the claim using M400B and include a letter from the surgeon detailing the clinical necessity to trigger independent consideration for payment.
- Ensure the procedure date and start time are accurately recorded to correctly apply after-hours premiums like E409 or E410 if the surgery occurs outside standard operating hours.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Anaesthesia: 7 basic units.
Assistant: Basic units are not listed. Payment requires independent consideration. See payment adjustment rules.
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