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R684

R684Shoulder arthroscopy setup

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Shoulder arthroscopy setup, includes when rendered debridement, synovectomy, removal of loose body(ies) and/or screw, drilling of defect or microfracture, and/or synovial biopsy.

When to Use

  • Use R684 as the primary setup code when performing arthroscopic debridement, synovectomy, or synovial biopsy in the shoulder.
  • Use R684 when performing arthroscopic removal of loose bodies or hardware (screws) from the shoulder joint.
  • Use R684 when performing arthroscopic drilling of a defect or microfracture procedure as the primary surgical intervention.

Common Pitfalls

  • Billing E478, E484, or E485 as add-ons when the service is considered a standard component of another major arthroscopic shoulder procedure performed in the same session.
  • Attempting to bill R684 in addition to other shoulder procedures that already include arthroscopic setup as a component, leading to automatic claim rejection.
  • Failing to recognize that E484 is mutually exclusive with R401, which will trigger a billing error if submitted together.

Billing Tips

  • Ensure that any additional arthroscopic shoulder procedures performed are not listed as components of R684 or the E-add-on codes to avoid duplicate billing denials.
  • Always verify the patient's age and the timing of the procedure to determine if age-based premiums or after-hours premiums (E409/E410) apply to the R684 fee.
Provider Fee$400.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

A shoulder procedure listed in the Shoulder section of the Schedule performed arthroscopically is eligible for payment in addition to R684 if that procedure is not described as a component of R684 or described by an E-add-on code to R684.

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