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R614
R614 – Elbow disarticulation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Elbow disarticulation is the surgical amputation of the arm through the elbow joint. As a surgical procedure, this service includes all applicable common elements as outlined in - of the Schedule. The fee for this service is for the surgeon's component (suffix A). Fees for surgical assistant (suffix B) and anaesthesia (suffix C) are calculated separately based on basic units and time units.
When to Use
- Use R614 specifically for formal disarticulation through the elbow joint, distinguishing it from R613 which covers amputation of the forearm.
- Select this code for traumatic or pathological cases requiring complete removal of the forearm at the elbow joint level.
Common Pitfalls
- Billing R614 in conjunction with other major forearm procedures on the same limb is often flagged as unbundling; ensure the procedure is distinct and not part of a more comprehensive amputation.
- Failure to document the specific anatomical level (elbow disarticulation) can lead to downgrades if the operative report suggests a more proximal or distal amputation.
Billing Tips
- Ensure the surgical assistant and anaesthesia components are billed separately using the appropriate suffixes (B and C) and relevant time/unit calculations, as R614 covers only the surgeon's fee.
- If the procedure is performed on a trauma patient, verify the Injury Severity Score (ISS) meets the threshold for the E420 trauma premium and document the score clearly in the chart to support the claim.
Provider Fee$289.50
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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