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R651
R651 – Temporomandibular ankylosis - with construction of condyle and ascending ramus
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Temporomandibular ankylosis, with construction of condyle and ascending ramus. This is a surgical procedure listed under the Musculoskeletal System section. The asterisk () in the title is present in the Schedule of Benefits but has no corresponding note on the source page.
When to Use
- Use R651 specifically for the surgical reconstruction of the condyle and ascending ramus in cases of TMJ ankylosis, distinguishing it from simpler procedures like R649 (TMJ arthroplasty) or R650 (TMJ condylectomy).
- Select this code when the operative report confirms the structural reconstruction of both the condylar head and the ascending ramus, rather than just a release of fibrous or bony adhesions.
Common Pitfalls
- Billing R651 in conjunction with R645 or R646 is a common audit trigger; ensure the procedures are distinct and not considered integral components of the primary reconstruction.
- Failure to document the specific anatomical extent of the reconstruction can lead to downgrades if the Ministry determines the procedure was a simpler arthroplasty rather than a full condyle and ramus construction.
- Attempting to bill a second surgical assistant without prior approval; R651 is not on the pre-approved list, and claims will be rejected without explicit authorization.
Billing Tips
- Ensure the operative report explicitly details the reconstruction of the ascending ramus to justify the higher fee compared to isolated condylar procedures.
- If the procedure is performed bilaterally, ensure the claim reflects the appropriate multiple procedure rules, as the assistant and anaesthesia units are tied to the major procedure performed under the same anaesthetic.
Provider Fee$666.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$232.35
Non-Anaesthetist Fee$232.35
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
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