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R628
R628 – Hip dislocation, late, after four weeks
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction for a late hip dislocation, defined as a dislocation that is four weeks or more old. This service is claimed with suffix A for the surgeon. See notes for assistant (suffix B) and anaesthesia (suffix C) billing.
When to Use
- Use for open reduction of a hip dislocation where the injury occurred four weeks or more prior to the procedure, indicating a chronic or neglected presentation.
- Use when the clinical documentation explicitly confirms the dislocation is 'late' or 'chronic' (>= 4 weeks) to distinguish it from acute reduction procedures like D043.
Common Pitfalls
- Attempting to claim R628 alongside D042 is a hard rejection; ensure the clinical record justifies the open reduction approach over the closed reduction typically associated with D042.
- Failure to document the date of the original injury in the operative report can lead to audit recovery if the 'late' status (>= 4 weeks) is not clearly substantiated.
Billing Tips
- Always append suffix A for the surgeon, and ensure your assistant and anaesthetist use suffixes B and C respectively to ensure proper processing of the base fee and any applicable premiums.
Provider Fee$774.90
Surgical Assistant Fee$87.57
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
Effective: April 1, 2025
Since Apr 2004, this fee has increased 0.0% vs 57.0% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
May not be claimed with D042 at the same time.
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