R602 – Pollicization
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This fee code is for a surgical procedure on the musculoskeletal system. Payment for the surgeon (suffix A) is a set fee that includes pre-operative, intra-operative, and post-operative care as defined in the Schedule of Benefits. Services for a surgical assistant (suffix B) and an anaesthesiologist (suffix C) are calculated separately based on a combination of basic units assigned to the procedure and time units. - For rules on calculating surgical assistant fees, see pages -. - For rules on calculating anaesthesiologist fees, see pages -.
When to Use
- Use R602 for the surgical transfer of a digit (usually the index finger) to replace a missing or non-functional thumb.
- Use this code for complex reconstructive hand surgery involving neurovascular pedicle transfer, distinguishing it from simpler tendon transfers or basic digit amputations.
Common Pitfalls
- Billing R602 in conjunction with other hand procedures without ensuring the 'multiple procedure' rule is applied to the surgical assistant and anaesthesiologist units.
- Failing to document the specific anatomical components of the pollicization, which can lead to audit scrutiny if the claim is flagged for review against simpler musculoskeletal codes.
- Attempting to bill additional surgical codes for the same site if they are considered 'incidental' or 'included' in the global fee of R602.
Billing Tips
- Ensure the operative report explicitly details the neurovascular pedicle dissection and transposition, as these are the defining clinical elements of a pollicization procedure.
- When performing bilateral pollicization or multiple procedures, ensure the assistant and anaesthesiologist units are calculated using the major procedure rule to avoid claim rejection.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
An appropriate operative report must be included in the patient's medical record.
All insured services must be documented in appropriate records that establish: 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.
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