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R639
R639 – Simple cyst, etc.
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R639 is for the surgical excision of a simple cyst or similar lesion from a bone within the pelvis and hip region. This procedure is listed under the Musculoskeletal System Surgical Procedures section, under the subheading for Pelvis and Hip excisions.
When to Use
- Use R639 for the surgical excision of a simple bone cyst located specifically within the pelvic or hip region.
- Use this code for benign, non-complex cystic lesions where the primary intent is excision, distinguishing it from more extensive procedures like R330 (curettage of bone cyst) which may involve more complex grafting or structural management.
Common Pitfalls
- Billing R639 for soft tissue cysts or superficial lesions; ensure the documentation explicitly confirms the lesion is intra-osseous to avoid rejection for incorrect anatomical site coding.
- Attempting to unbundle R639 with other musculoskeletal procedures performed in the same operative field; ensure that the excision is a distinct, separate procedure if billing alongside other surgical codes.
Billing Tips
- Always verify the patient's age at the time of the procedure to automatically apply the appropriate age-based premium (e.g., AGE_PREMIUM_5Y_TO_16Y), as these are critical for maximizing the surgical fee.
- If the procedure is performed as an emergency or delayed due to an intervening surgical emergency, ensure the claim includes the correct after-hours premium (E409 or E410) to increase the procedural fee by 50% or 75% respectively.
Provider Fee$338.75
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
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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