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R642
R642 – Closed reduction/internal fixation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This procedure realigns a slipped epiphysis (the growth plate at the head of the femur) without a large open incision (closed reduction) and secures it in place with internal hardware such as pins or screws (internal fixation). This service is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees.
When to Use
- Use R642 for the percutaneous pinning of a Slipped Capital Femoral Epiphysis (SCFE) where the reduction is achieved without an open arthrotomy.
- Select R642 when internal fixation is performed using cannulated screws or pins to stabilize the femoral head following a closed reduction maneuver.
Common Pitfalls
- Billing R642 alongside open reduction codes (e.g., R600 series) is a common audit trigger; ensure the operative report explicitly describes a closed technique to justify the code selection.
- Failure to document the specific age-based premium (e.g., 5-16 years) on the claim will result in underpayment, as these are not automatically applied by the system.
Billing Tips
- Always verify if the procedure qualifies for the E420 trauma premium by confirming the Injury Severity Score (ISS) is documented in the chart, as this cannot be combined with after-hours premiums.
- When performing bilateral procedures, ensure the secondary procedure is billed with the appropriate bilateral reduction modifier to avoid automatic rejection for duplicate services.
Provider Fee$502.30
Surgical Assistant Fee$77.46
Anaesthetist Fee$127.68
Non-Anaesthetist Fee$127.68
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
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