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R617
R617 – Forequarter amputation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Forequarter amputation. This is a major surgical procedure involving the disarticulation of the shoulder and removal of the clavicle and scapula.
When to Use
- Use R617 specifically for a formal forequarter amputation involving the disarticulation of the shoulder along with the excision of the clavicle and scapula.
- Use this code for radical oncological resections where the entire upper extremity and shoulder girdle must be removed to achieve clear margins.
Common Pitfalls
- Billing R617 when only a shoulder disarticulation is performed, which should instead be coded under R616.
- Failing to document the specific removal of both the clavicle and scapula, which is a mandatory requirement for the R617 definition.
- Attempting to bill additional musculoskeletal excision codes separately; R617 is a comprehensive procedure and includes the associated structures.
Billing Tips
- Ensure the operative report explicitly details the removal of the clavicle and scapula to support the R617 claim during potential audits.
- If the procedure is performed as an emergency, ensure you append the appropriate E409 or E410 premium to the R617 fee to maximize the surgical reimbursement.
Provider Fee$490.95
Surgical Assistant Fee$125.10
Anaesthetist Fee$232.35
Non-Anaesthetist Fee$232.35
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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