R650 – Temporomandibular ankylosis - with insertion of prosthetic device or muscle flap
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This surgical service is for the treatment of temporomandibular ankylosis. The procedure involves the insertion of a prosthetic device or muscle flap. This is a comprehensive surgical service and includes pre-operative, operative, and post-operative care as outlined in the Schedule of Benefits.
When to Use
- Use R650 specifically for the surgical release of temporomandibular joint ankylosis where a prosthetic device is inserted to maintain joint space.
- Use R650 when a muscle flap (such as a temporalis muscle flap) is utilized to reconstruct the joint or prevent re-ankylosis following the release procedure.
Common Pitfalls
- Do not bill R650 if the procedure is a simple arthroplasty without the insertion of a prosthetic device or the use of a muscle flap; use R649 instead.
- Avoid billing R650 in conjunction with R651, as these represent distinct surgical approaches to TMJ pathology and are generally considered mutually exclusive for the same joint site.
Billing Tips
- Ensure the operative report explicitly details the type of prosthetic device or the specific muscle flap used, as this is the primary clinical justification for the R650 fee over lower-complexity codes.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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