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R611
R611 – Amputation - Hand - all metacarpals
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Amputation of the hand, involving all metacarpals. This is a surgical procedure listed under the Musculoskeletal System section of the OHIP Schedule of Benefits.
When to Use
- Use R611 when performing a formal amputation of the hand specifically involving all metacarpals, distinguishing it from R610 which covers amputation of a single digit or ray.
- Select R611 for traumatic or elective surgical procedures where the level of amputation necessitates the removal of the entire metacarpal complex, rather than more distal procedures like R606 or R608.
Common Pitfalls
- Billing R611 in conjunction with E409 or E410 after-hours premiums while also attempting to claim E420 trauma premiums; these are mutually exclusive per the Schedule of Benefits.
- Failing to document the specific involvement of all metacarpals, which may lead to a downgrade to a lower-valued amputation code during an audit if the operative report only describes a partial hand amputation.
Billing Tips
- Ensure the operative report clearly defines the level of amputation to justify the use of R611 over R610, as the fee difference reflects the increased complexity of a full metacarpal-level procedure.
- If the procedure is performed on a patient under 16 years of age, verify if the Injury Severity Score (ISS) qualifies for the E420 trauma premium, as this provides a significant 50% increase over the base fee.
Provider Fee$289.50
Specialist Fee$0.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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