R584 – Tenoplasty - one
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a single tenoplasty, a surgical procedure to repair a tendon in the knee. This procedure has 6 basic units for an assistant and 7 basic units for anaesthesia. For each additional tenoplasty performed during the same operative session, use add-on code E050. This is a surgical procedure and is eligible for assistant and anaesthesia services, which are calculated based on basic units and time units. Refer to for assistant fee calculation and for anaesthesia fee calculation.
When to Use
- Use R584 for a primary surgical repair of a single knee tendon where the procedure is performed in a hospital setting.
- Use R584 as the base code when performing multiple tendon repairs in the same knee, with subsequent repairs billed using E050.
Common Pitfalls
- Billing R584 for minor soft tissue procedures or simple debridement that do not meet the definition of a formal tenoplasty.
- Failing to document the specific number of tendons repaired, which leads to audit scrutiny when E050 is appended to R584.
Billing Tips
- Always append E050 for every additional tendon repaired during the same session to ensure you are compensated for the full scope of the surgical work.
- Verify that the operative report explicitly details the repair of each tendon to justify the use of R584 plus any applicable E050 add-ons.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
As per the Health Insurance Act, all insured services must be documented in the patient's medical record. The record must establish that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary.
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