R590 – GT trochanteric/ischial
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical excision of a greater trochanteric (GT) or ischial bursa, a fluid-filled sac near the hip joint. This procedure is performed to relieve pain and inflammation associated with bursitis.
When to Use
- Use R590 for the formal surgical excision of a symptomatic greater trochanteric or ischial bursa that has failed conservative management.
- Use R590 when the procedure involves the complete removal of the bursal sac, distinguishing it from simple aspiration or injection procedures which are billed under different codes.
Common Pitfalls
- Do not bill R590 for simple aspiration or corticosteroid injection of the bursa, as these are not surgical excisions and will be rejected or flagged during audit.
- Avoid billing R590 in conjunction with other major hip surgeries unless the excision is a distinct, separate surgical site, as it may be considered inclusive to more comprehensive procedures.
- Ensure the diagnosis code reflects bursitis, as billing R590 without clear documentation of chronic bursal pathology increases the risk of post-payment review.
Billing Tips
- If the procedure is performed on an emergency basis after hours, ensure the appropriate non-elective premium (E409A or E410A) is submitted on the same claim to capture the 50% or 75% fee increase.
- If the patient is under 16 years of age, remember to append the relevant age-based premium to the R590 claim to receive the mandatory percentage increase for pediatric surgical services.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records. The record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary, as per .
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