R649 – Temporomandibular ankylosis - excision bone or fibrous block
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Excision of a bone or fibrous block for temporomandibular ankylosis. This is a surgical procedure listed in the Musculoskeletal System section of the Schedule of Benefits. The surgeon's fee is a flat rate. The anaesthetist fee is calculated based on 7 base units plus time units. The surgical assistant fee is calculated based on 6 base units plus time units. Refer to the Surgical Assistants' Services (-) and Anaesthesiologists' Services (-) sections of the General Preamble for unit calculation rules.
When to Use
- Use R649 specifically for the surgical excision of a bone or fibrous ankylotic block within the temporomandibular joint.
- Use this code when the clinical objective is the restoration of joint mobility through the removal of pathological tissue, distinguishing it from simple arthroplasty or diagnostic procedures.
Common Pitfalls
- Billing R649 in conjunction with other TMJ surgical codes without clear documentation of distinct, separate procedures may lead to rejection for unbundling.
- Failing to document the specific nature of the ankylosis (bone versus fibrous) can complicate audit reviews, as the code covers both but requires clinical justification for the surgical approach.
Billing Tips
- Ensure the surgical assistant and anaesthetist claims explicitly reference the base units (6 and 7, respectively) as defined in the General Preamble to avoid payment processing delays.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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