R608 – Phalanx, metacarpal or metacarpophalangeal joint amputation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical amputation of a metacarpal bone or at the metaphalangeal joint. The fee code E583 is payable for each additional metacarpal or metaphalangeal joint amputation performed during the same operation. (Source: )
When to Use
- Use R608 for the primary amputation of a single metacarpal bone or at the metacarpophalangeal joint.
- Use R608 in conjunction with E583 when performing multiple amputations of the same type during a single operative session.
Common Pitfalls
- Do not bill R608 for distal phalanx amputations, which are covered under separate codes like R606.
- Do not assume surgical assistant coverage; R608 has no listed assistant units, requiring M400B and a letter of justification to the Ministry.
- Failure to document the specific anatomical level of the amputation can lead to audit rejections if the procedure is misclassified as a minor excision.
Billing Tips
- Always append E583 for every additional digit or metacarpal amputated beyond the first to ensure full compensation for multi-digit trauma cases.
- If an assistant is medically necessary, ensure the surgeon's letter explicitly details the complexity or patient-specific factors to satisfy the M400B authorization requirement.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Anaesthesia: 7 basic units. (Source: )
Assistant: No basic units are listed for an assistant. Payment requires authorization by a medical consultant following submission of a letter from the surgeon outlining the reason an assistant was required. When authorized, the number of basic units is that listed under 'Anae' (7 units). Claim should be submitted as M400B. (Source: )
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